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Roche Coaguchek


James

Did you find the Roche Coaguchek easy to use?  

14 members have voted

  1. 1. Did you find the Roche Coaguchek easy to use?

    • Easy to use
      6
    • Easy when you know how
      2
    • Some difficulty
      2
    • Very difficult
      0
    • Have not tried it yet
      4
    • Use an INR checker made by another manufacturer
      0
    • Other
      0


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I have had hundreds of blood tests but today I had my first INR check using the Roche Coaguchek System (see www.coaguchek.com for product details and photo).

I have often heard that XYZ hospital/dental department has a handheld INR testing kit but usually the news goes hand in hand with statements like "we're not allowed to use it" or "someone else knows how it works but I don't" or "we've run out of supplies for it".

So when my dentist suggested checking my INR this way I was fascinated with what my first impressions would be. First I was told to brace myself for the finger stab (used to get a drop of blood) which proved significantly easier than drawing blood via hypodermic and hardly hurt at all. Although my fingertips are still sensitive 12 hours later. Then a drop of my blood was placed on the testing strip, we waited and then up came an error message. Oh dear, we have to go again (glad I wasn't paying for the supplies).

We used the other hand for the second test, so as not to contaminate with 'old' blood. Another nurse took over. We waited for the indicator to say it was ready (aha, we should have been told that before the first test) and then dropped more blood onto a fresh testing strip. One minute later we got the result of 4.4. Way too high for dental work which had to be postponed to a later date (c'est la vie).

I had suspected my INR had gone wobbly. I was unwell on the weekend and had been sick in the middle of the night and woke up with broken blood vessels around my eyes (it looked like I had two black eyes). So I was quite chuffed to know that the system had given me important news that would affect today's dose of warfarin. By comparison, I am still waiting for the postman to deliver Friday's 'traditional' blood test result to me although they would have called me if there was a problem.

Overall, I reckon the Coaguchek seems to work best in experienced hands, but there are some clear benefits to getting a quick INR result. Having said that it still took 40 minutes to get someone to conduct a 1 minute test. I wouldn't mind having one in the home for occasional testing when I am concerned something is wrong with my INR but would still appreciate the value of a traditional test, plus some TLC from a caring nurse. My visits to the blood testing clinic is also a social event and I meet lots of interesting staff and patients there too, so that is a factor too.

Let the testing commence...

If you have used a Roche Coaguchek System please vote in this poll.

What do you think about it?

If you have any comments about another system (such as the ProTime Microcoagulation System) please just give me brief product and manufacturer details and I will start a new poll just for that product (so save your comments until a new poll is ready).

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  • 5 months later...
Guest Anne Holmes

James,

Coaguchecks cost nearly ?400. Whilst I agree they are as easy to use as blood glucose monitors, I don't feel the price merits individuals buying these 'machines'. One cannot change one's own dosage of medication anyway, so a haematologist has to be involved.

It is very useful for dentists and GPs to have so they can check INR levels before certain procedures, and indeed, my brother in law in Cheshire actually has his INR done by this method at his health centre and dosages changed there and then. Perhaps this is the future scenario - these monitors being used instead of blood being taken the old fashioned way.If it does come to pass I for one will be pleased, as since Chemotherapy this year, my veins have become very difficult to find.

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I don't know what kind exactly that my DRs have (as I have not been on warfarin for about 2 years now) but this is the type of machine/device that the nurses used to test my INR. Only when I was in hospital did I have my INR checked by drawing blood and sending it off.

They had a thing that looked like a biro but it spiked your finger to get a drop of blood which they then put on the little strip and waited for the result. They then put the result into a computer program which figured out the warfarin doseage.

This way of doing it particularly suited me as I tend to faint when needles are stuck in to me!! I can deal with a quick spike of the finger though!

Occasionally we had to do two tests as the first one didn't work but overall I found it very good!!

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  • 8 months later...
Guest minty
:P Does anyone know if there is anyplace to get hold of a coaguchek at a price cheaper than ?399 (which is what Roche charge.) Any help would be great, thanks! :)
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  • 1 month later...

Hello everyone, I am new to this forum so I hope I am entering this reply correctly:

Yesterday I had a demonstration of the latest Roche machine - the CoaguChek XS at my anti coag clinic. The machine was easy to use and gave similar results to the lab one taken a few minutes earlier:

Lab INR = 2.08

1st XS result = 2.0

2nd XS result = 1.9

I did the 2nd one myself.

I will buy a machine in order to keep a more frequent check on my INR and to save the hours spent travelling to and from the clinic. The Roche rep told me that they had "Sales" from time to time when the machines are reduced to ?350 instead of ?400, but unfortunately they have just finished one. But I will probably go ahead anyway. I did wonder if you could buy one on Ebay....!

Ray

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  • 2 weeks later...

Well I could not find a machine on Ebay(!) so I bought the full price one from Roche - ?400. But it has proved useful: I have since had another clot after my original DVT. This time just a surface one (phlebitis) but it was a clear sign that my INR should be increased from 2-3 up to 3-4. The Roche machine showed it was running at 1.9 so it was useful in conversation with the hospital that I should increase my Warfarin dose.

Only problems I have had so far are:

The GP prescribed the wrong test strips at first (make sure you get the right ones e.g. the latest machine is the XS model)

I found it difficult to get enough blood from my finger at first. But if I let my arm hang down by my side for a minute before and just after I used the pricker then I got plenty.

Ray

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  • 4 weeks later...
  • 4 weeks later...

I am very pleased to report that Roche have given their approval for me to become a reseller of the Coaguchek system. It's taken me four months to get their approval but I'm sure it was worth the wait. I will be putting together a product page for more information and will let you know when that is ready.

If you are thinking about buying a Coaguchek please drop me a line.

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  • 4 months later...
Guest desertrat

James,

I haven't been here in awhile so forgive me if this isn't in the proper place. I have a Hemosense INRatio monitor and would be happy to comment on it.

Jill

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  • 2 months later...
Guest Lisataylor

hi everyone..

it seems that the concept behind this idea is a really good one. Im 17 and need wafarin daily and blood tests almost on a weekly basis. As a result my veins have gotten extremely weak and theyve started too use veins in my feet just too get blood. In August of this year im having a port put in my chest so as they can draw blood more easily. All of this wouldnt be nessescary if they could use just a finger prick!! Im only 17 and my veins have packed it in within 3 years of the constant blood tests!

Im sure theres others out there that will agree that having blood tests on a regular basis gets harder and harder everytime!!

anyone else in similar situation?

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We managed to secure a discount from Roche for reselling the Coaguchek XS.

However, because of our tax status (i.e. because we aren't a registered charity) the product is liable for VAT of 17.5% which makes the end-user price more expensive than if you bought direct or through your local chemist. Obviously this is catch-22 because the main reason for wanting to sell the system was to generate income that would lead to us setting up a charity. Roche are not liable for the same amount of VAT. It isn't a level playing field.

Roche haven't responded to our requests to pay a commission but we've decided to go ahead and publish the page we put together for them here http://www.protein.org.uk/coaguchekxs.php

We will not earn any income for sales generated through our product page. If you decide to buy or make any enquiry on their freephone number please mention that you saw their product on our web site and get them to report it back through to Lewes Sales Office. Maybe that will persuade them to support our web site in another way.

Edited by James
Removed Contact Name
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  • 2 weeks later...
Guest Liz Peters

Has anyone else found a problem with being able to obtain the testing strips for this machine on the nhs?

My twin sister was given the ok from her doctor to get these strips on the nhs - so she has bought a machine. She has been back in hospital recently and was told to test herself daily for a while. So she asked for a prescription for some more strips.

Now the receptionists have told her that they are too expensive and she has been refused them!! She is understandably very upset, after spending so much money. She is a locum pharmacist who has been on sick leave since March, so is not being paid until she goes back to work. She has had a dvt and 2 pe's - her inr is all over the place at the moment. She has one vein left now, all the others have collapsed and it is taking the nurse minutes to get blood each time.

She has low protein s - but trying to explain how vital it is to be able to check her levels seems to be falling on deaf ears. I find it so hard trying to console her - her life revolves round testing, and the coagucheck was making such a difference. She cannot drive due to the pain relief she is on, and the nearest clinic is 8 miles away, so her life is spent dealing with this.

Can anyone offer any advice as to how she could approach the doctors regarding this matter? As a pharmacist she knows how much it can cost for strips - but she knows that diabetics can recieve up to 3 boxes of their strips a week - so why should it make a difference if you have low protein s?

Any advice I receive will be grateful - many thanks

Liz :blink:

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There is a contact number for Roche on our web page at http://www.protein.org.uk/coaguchekxs.php

The strips are approved by the NHS for prescription. Perhaps you could speak to Roche and get them to contact your doctor and sort things out. Lots of drugs are expensive... haemophiliacs get their (expensive) supplies free of charge. No doctor should be putting finances ahead of health considerations, and even though the strips do cost a fair bit it's still a whole lot cheaper than a stay in hospital.

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Guest Liz Peters

Many thanks for your quick reply James,

This site has been invaluable to me since I have been diagnosed - and I have found answers to the many questions I have - which usually enter my mind if I am awake at 2 in the morning!

Best wishes

Liz :blink:

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  • 2 months later...
Guest lsgordon

Forgive me for being so late in joining the conversation . . .

Everytime you have your INR checked in (most parts of) England you have to have a blood draw? I live in San Diego, and ever since my diagnosis four years ago and the PEs that came with it I have been going to what we call the Coumadin Clinic. Once a week anyone and everyone who is on coumadin for whatever reason goes to the clinic and one little finger poke later you have your dosages adjusted right then and there. I've always been fairly unstable so I'm in there every week. And then if you're really high or really low via the CoaguCheck, you go for a blood draw and a D-dimer test. The whole system is easier for the patients and easier for the clinicians who are monitoring the patients. And I think that the patients get better care- you are being monitored by pharmacists who only deal with coumadin patients, not your GP who has never even heard of Protein S.

I was actually looking into getting my own INR machine a few years ago because I was sick of going to the clinic every week, and my pharmacist told me that there is a service that you can subscribe to that will help you to adjust your dosages once you have taken a reading. You call in and talk to a pharmacist that deals with coumadin patients. It might be something to look into for those of you that have the Roche machines.

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I too have been having INR fingerstick tests for almost 13 years. UMASS Hospital in Worcester, MA was one of the developers of this technology and I was fortunate enough to be one the first patients. I now go to the lab at my local physicians office to have my finger stuck. The accuracy has been very good over the years and a couple of times a year they do a fingerstick and a vein draw just to double check.

As a resident of Massachusetts, I have had both Blue Cross and Fallon health insurance. Neither company would cover the cost of the machine or the monitoring service for patients who have Protein S. They WOULD cover the cost for patients with certain heart valve issues. At first I was angry and tried to fight their ruling, but after much thought, I backed down. What made me give up in the end was the monitoring service that you had to be a part of. After fingersticking and getting the result, you would have to call it in to the service who in turn would talk to your physician and get back to you. This could take a day or so. Through the lab at the doctors office, the RN has the results immediately and emails me within hours with any changes to my dosage. Great customer service!

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  • 10 months later...
Guest julieanne

Hey :)

I am currently having my INR done by the Coagucheck at my doctors surgery...the nurse does it

However ...it had a read of 1.9 recently... so the nurse sent a sample taken 2 minutes after the first check to the hospital... it came back at 3.2 :rolleyes:

We discussed this and calibration of the machine was talked about, but I was assured that the machine was ok :)

Now I'm thinking that a 3.5 read that i also had been done recently may of actually been a lot higher...5.6..which caused me to attend casualty with internal bleeding :(

Should I go back to the hospital for my checks? and why such a difference ..I know different machine give a slight +/- but I do need a correct read..whichever machine is used

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The machine is as accurate as it needs to be... but only with a correctly administered and clean sample. The timer that takes you through the various steps of the sample reading needs to be followed and the drop of blood delivered exactly onto the testing strip. It can be quite fiddly sometimes and it takes a bit of practice to get it right.

My GP has a professional testing machine (it costs about 5000 GBP so I'm told) and that is used for my checks now - it uses the vacutainer sample drawn from my arm, rather than a testing strip.

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  • 5 months later...

I have used both INRatio and Coagucheck.

In my personal experience, INRatio requires less blood, and the finger stick is considerably less painful; however, you have to be a lot more accurate with your blood sample. My doctors generally used a pipette to pull the blood then direct it exactly where it needed to go. The coagucheck needs more blood, the finger stick is painful up to 24-48 hours later (sometimes I get a bruise) but not as difficult to test.

When I was first being tested, it was at my pulmonologist's office. They all could use the machine to test me, even the assistants. They managed my coumadin with the INRatio until I was free of the PE. They recommended that I go see a hematologist of whom tested me to find out that I have PSD. Since then, they have been managing my coumadin with the Coagucheck in their onsite lab. I need my fingers for my job, so I hate the soreness that follows. They only draw blood if it's over 4 because according to the lab tech, the machine is only accurate up to that point, and once or twice a year for checking accuracy.

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