What question did this study set out to answer?

To evaluate the efficacy of patient education alone versus education combined with INR self-monitoring on anticoagulation stability in older patients receiving warfarin therapy.

July 20, 2004British Journal of HaematologyOpen Access

The value of education and self‐monitoring in the management of warfarin therapy in older patients with unstable control of anticoagulation

View Full Paper

Ask AI

Bookmark

Why the study?

Does education with or without INR self-monitoring improve time in therapeutic range in older patients with atrial fibrillation and unstable warfarin control?

Population

125 patients aged 65 years or over with atrial fibrillation taking warfarin for at least 12 months, with…

Comparison

Education about warfarin alone or education… vs Usual clinic care (n=40).

Design

RCT, Randomized to continue with usual clinic care or receive education…

Follow-up

6 months

Authors

TKTayyaba KhanUniversity of Central Punjab FKFarhad KamaliNewcastle upon Tyne Hospitals NHS Foundation Trust PKPatrick KestevenNewcastle upon Tyne Hospitals NHS Foundation Trust

Discussion

Member takes

Implication

Supports education plus self-monitoring to improve TTR in older AF patients with unstable warfarin control; extends evidence for combined interventions in this population.

Key Points

To evaluate the efficacy of patient education alone versus education combined with INR self-monitoring on anticoagulation stability in older patients receiving warfarin therapy.
Randomized trial conducted in 125 patients aged ≥65 years with atrial fibrillation on warfarin for ≥12 months with unstable INR control (INR SD > 0.5 over prior 6 months).
Participants were randomized to usual clinic care (n=40) or warfarin education (n=85); the education group was further randomized to INR self-monitoring (n=44) or return to clinic (n=41) for 6 months.
Time in therapeutic range significantly increased from baseline in the education plus self-monitoring group (57.0% vs. 71.1%; mean difference 14.1; 95% CI: 6.7–21.5; P < 0.001) and education group (61.1% vs. 70.4%; mean difference 8.8; 95% CI: -0.2–17.8; P = 0.054) versus usual care (60.0% vs. 63.2%; mean difference 3.2; 95% CI: -7.3–13.7).
INR standard deviation decreased significantly across all groups (education and self-monitoring fell by 0.24, P < 0.0001; education alone fell by 0.26, P < 0.0001; control fell by 0.16, P = 0.003), but inter-group differences were not statistically significant (0.26 ± 0.30 vs. 0.16 ± 0.30, P = 0.10).

Structured PICO

Does education with or without INR self-monitoring improve time in therapeutic range in older patients with atrial fibrillation and unstable warfarin control?

Population

125 patients aged 65 years or over with atrial fibrillation taking warfarin for at least 12 months, with unstable control (standard deviation of INR >0.5 over the previous 6 months).

Intervention

Education about warfarin alone (n=41) or education combined with INR self-monitoring (n=44).

Comparator

Usual clinic care (n=40).

Outcome

Percentage time within the therapeutic range for the 6 months following intervention.surrogate

Patient education combined with INR self-monitoring significantly improves time in therapeutic range in older patients with atrial fibrillation and unstable warfarin control.

Cite This Study

Khan et al. (2004) studied this question.

synapsesocial.com/papers/6a70536b26770c2b8de076fc https://doi.org/10.1111/j.1365-2141.2004.05074.x

Topics

Atrial fibrillation Anticoagulation in AF Persistent AF management

View Full Paper

Ask AI

Bookmark

Implication

Supports education plus self-monitoring to improve TTR in older AF patients with unstable warfarin control; extends evidence for combined interventions in this population.

The value of education and self‐monitoring in the management of warfarin therapy in older patients with unstable control of anticoagulation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

The value of education and self‐monitoring in the management of warfarin therapy in older patients with unstable control of anticoagulation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

Also Consider