Key result
Warfarin self-management training succeeds in ~74% of patients, with manual difficulty driving most dropouts.
Why the study?
Does self-management training improve point-of-care testing capability in adults with a long-term indication for warfarin?
RCT (n=608)
Central telephone randomisation
Yes
Does self-management training improve point-of-care testing capability in adults with a long-term indication for warfarin?
While patient self-management of warfarin is feasible, a substantial proportion of unselected adults may decline participation or struggle with the point-of-care testing procedure.
Answers are grounded in this paper and cite their sources.
Self-management training succeeds in most but not all warfarin patients; extends feasibility evidence while cautioning against unselected implementation.
Self management of warfarin treatment by patients, using a point of care coagulometer for testing international normalised ratios, is comparable to home glucose monitoring and may provide a robust model of service provision. 1 2 Self management can lead to improvements in patients' self efficacy, closer adherence to treatment, and increased control of treatment with oral anticoagulants. 3 We report data on the effectiveness of the training programme used for a clinical trial (self management of anticoagulation: a randomised trial, SMART) which aimed to evaluate clinical and cost effectiveness of self management compared with routine care. UK guidelines indicated that training to a standard acceptable is essential, although the nature of the training was not clearly defined.
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Murray et al. (2004) conducted an RCT in Long-term indication for warfarin (n=608). Self management of warfarin treatment vs. Routine care was evaluated on Successful completion of self-management training.
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