Warfarin therapy (WT) is indicated for managing oral anticoagulation therapy (OAT) in persons with atrial fibrillation, deep vein thrombosis, pulmonary embolism, or a mechanical heart valve to reduce the risk of a stroke. A stroke is the leading cause of disability and the third leading cause of death in the United States, with an estimated annual total cost of $57.9 billion. Given the aging of our population, it is projected that 7.5 million individuals will have atrial fibrillation in the United States by the year 2020 based on an expected prevalence of 13.5% for individuals greater than 75 years of age. The project manager cared for 50 patients on WT during the project. Medical expertise is needed to manage OAT in a safe manner. Frequent international normalized ratio (INR) testing was required until the recommended range was achieved. The quality of life was affected for persons due to the numerous food, alcohol, and drug interaction precautions, because of OAT, and the need to return to the physician’s office for blood tests. There were significant gaps associated with WT: a lack of patient knowledge of WT; a lack of knowledge by the healthcare provider (HCP) that self-testing was a viable option for managing WT. The evidence-based framework for this project was the precede/proceed planning model. The purpose of this project was to change the methodology of how the INR was tested in this rural farming community.
