Expert opinion on key aspects of managing education school for patients taking vitamin K antagonists

The leading problem in the use of vitamin K antagonist (VKA) therapy is the complexity and the need to maintain the international normalized ratio (INR) within therapeutic window of at least 60% of the treatment time. Obviously, the optimal solution to this problem in the context of modern technological capabilities is its self-monitoring by a patient and understanding the need to adjust the VKA (warfarin) dose to achieve the target INR values (independently or with the help of a physician’s consultation). Portable devices and a model of self-monitoring of anticoagulant therapy (coagulometers) has reduced the rates of thromboembolism, major bleeding, and all-cause mortality, and confirmed its high cost-effectiveness. An important aspect for successful INR self-monitoring is comprehensive patient education, implemented within the specialized schools. Such educational programs provide patients with the necessary knowledge about warfarin, the importance of regular INR monitoring, the aspects of self-monitoring, possible complications and actions in emergency situations. The combination of structured training and subsequent INR self-monitoring contributes to a significant increase in therapy adherence and improved clinical outcomes. The results of systematic reviews and randomized trials confirm that patient participation in educational programs reduces the risk of thromboembolic and hemorrhagic events and increases the overall effectiveness of treatment. The aim of the work was to formulate the key aspects of managing an education school for patients taking VKA. The combination of educational programs, active follow-up, coagulometers, and remote monitoring forms a holistic model for managing patients receiving VKA that meets modern requirements for clinical efficacy, safety, and cost-effectiveness.