Warfarin Therapy and Improved Anticoagulation Control by Patient Self-Management

The landscape of oral anticoagulant therapy has significantly changed over the last decade with non-vitamin K oral anticoagulants (NOACs) now preferred over conventional vitamin K oral anticoagulants (VKAs), such as warfarin, for a large proportion of patients requiring chronic anticoagulation.[1] All NOACs have shown a favourable risk/benefit profile compared with warfarin, with significant reductions in intracranial haemorrhage, stroke and systemic embolism.[2] Their predictable anticoagulant effect without the need for routine monitoring is another attribute which makes them an attractive choice. Nevertheless, warfarin remains a useful drug as many patients requiring OAC have contraindications to NOAC therapy, such as mechanical valve replacement, antiphospholipid syndrome or severely reduced renal function, and globally the NOACs are not always a viable option (either availability to prescribe and/or cost) for many patients.