PB2277 IMPROVE THE QUALITY OF LIFE IN CHILDREN: ORAL ANTICOAGULATION IN PEDIATRICS THROUGH INFORMATIC APPLICATIONS
Authors: Martínez R. Martos , Platero M. Yuste , Arias E. Gonzalez , Martinez L. Bermejo , Alvarez P. Beltran , Martinez A. Pascual , Sillero P. Llamas 
Published: June 2019

Background:

Pediatric patients with oral anticoagulant therapy, require periodic controls to monitor treatment,causing multiple trips to health centers with the consequent deterioration in the quality of life of children and their families and loss of family concilation.In the era of new technologies, making available to patients resources that facilitate, integrate and improve the monitoring of their diseases, should be included as a main objective.

Aims:

This project consists of correct control the oral anticoagulation of pediatric patients(<16y) in treatment with antivitamin K drugs through informatics applications that prevent the successive visits of the child and their families to health centers, improving the quality of life (avoiding displacement), humanizing the treatment and promoting an efficient management of health resources. In addition, the quality of care (which allows the child to be better anticoagulated with narrower and more personalized controls) implies and makes the child responsible for his treatment, by favoring coagulation controls in an optimal and reliable environment (family and home), which generates a closer and more human follow‐up.

Methods:

All patients are evaluated and their parents are informed of the program and they are explained how to perform coagulation control in the home with a portable coagulometer.The informatic circuit is verified, the result obtained is sent through the web and the result of the treatment and the date of the next control sent and validated by a haematologist is received in a few minutes.

Once the test has been carried out correctly, the coagulometer and the strips are given to the relative (duration 6 months) to check the proper functioning of the same after that time.Being pediatric patients,for ethical considerations,all recommendations,advice and treatments are made through parents. All analytical data and those related about complications are collected through medical program. As an additional security measure, a telephone and e‐mail address are provided for the family for possible complications(both technical and clinical).

Results:

6 patients included (5♂/1♀), age ranges: 1‐8y. All anticoagulated for antithrombotic prophylaxis. In terms of quality of care, 95% of the INR controls have been in an adequate range without visits to the emergency department due to problems derived from anticoagulation (bleeding/thrombosis). For quality of life and humanization,100% of families feel very satisfied with the program,with NPS (net promoter score) well above the average in the patient experience surveys. 100% would recommend it to other families. The children emphasize not having to go to the hospital and not lose their usual routines (do not lose school). Children also feel more secure and responsible for the treatment because they are their parents and in their usual environment where coagulation controls are performed. For families,the satisfaction is for not having to miss work days, not having to travel to the hospital, but above all, the greatest satisfaction is seeing the happiness of their children.

Summary/Conclusion:

This program is a novel and innovative project that makes compatible new technologies and medical care, where we improve the quality of care, with a closer and more correct control of anticoagulation and the improvement of health resources. But above all it is a project where the quality of life of the children and their families prevails, humanizing the medical processes and making an efficient management of the pathology of these small patients.