OBJECTIVES: The objectives of the current study is to determine the extent of awareness and the level of understanding about INR testing among patients undergoing oral anti-coagulation (OAT) therapy and to determine whether their INR values are within therapeutic range as measured by Coagucheck on-site. METHODS: A prospective cross-sectional pilot study was carried out in a cardiac center. During this study, patients fulfilling the inclusion criteria were enrolled into the study. For each patient demographic, diagnosis, past medication profile, anti-coagulation drug prescribed, and duration of OAT, hematological findings and level of INR awareness was recorded.  RESULTS: We interviewed 205 patients, and enrolled 90 patients. Patient population recruited in the study was 53 males and 37 females and INR was determined on-spot for these patients by CoaguChek. Results indicate that more patients lacked awareness than aware of the importance of INR. Among 63 patients who were unaware about the significance of regular INR testing, 74.60% get their INR tested only if asked by a physician, 22.22% get their INR tested on a monthly basis and 3.17% get their INR checked every week. Whereas, among the 27 patients who were aware, 70.37% gets their INR tested on a weekly basis, 25.92% gets tested on a monthly basis and only 3.70% do it only if asked by a physician. Results also revealed that a greater proportion of the patients in the “lack of aware group” have INR values that are beyond the therapeutic range.  Of the total of 7 Bleeding events reported by patients in this study, 6 were reported by patients who belonged to the lack of aware group. CONCLUSIONS: Our study demonstrates that ignorance regarding the significance of INR has impact on OAT.  Patient education in conjunction with on-site INR testing by the pharmacist will both save lives and improve therapeutic outcome.