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October 9, 2003Journal of Internal MedicineOpen Access

Self‐management of oral anticoagulation: long‐term results

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Why the study?

Does a structured teaching program for self-management of oral anticoagulation improve long-term INR control and quality of life in patients requiring anticoagulation?

Population

178 patients with indications for oral anticoagulation

Comparison

Structured teaching and treatment programme for… vs Baseline values

Design

Cohort, Initial part was randomized controlled; long-term follow-up was a…

Follow-up

5 years

Authors

PSP. T. SawickiNicolaus Copernicus UniversityBGBenjamin GläserHebrew University of JerusalemCKCaroline KleespiesEvidence Based Research (United States)

Discussion

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Overview

Long-term self-management was associated with improved INR control and low event rates; leaves open efficacy versus usual care in randomized trials.

Structured PICO

Does a structured teaching program for self-management of oral anticoagulation improve long-term INR control and quality of life in patients requiring anticoagulation?

P
Population
178 patients with indications for oral anticoagulation
I
Intervention
Structured teaching and treatment programme for self-management of oral anticoagulation (self-monitoring and self-adaptation of cumarin dosage)
C
Comparator
Baseline values (initial control group crossed over to the self-management programme after 6 months)
O
Outcome
Long-term compliance, accuracy of anticoagulation control (INR within target range), treatment-related quality of life, and bleeding and thromboembolic complications at 5 yearssurrogate

Long-term self-management of oral anticoagulation is associated with sustained improvements in INR control and quality of life, alongside low rates of bleeding and thromboembolic complications.

Limitations

  • Control group participated in the self-management programme after 6 months, precluding long-term randomized comparison of complications

Cite This Study

Sawicki et al. (2003) studied this question.

synapsesocial.com/papers/6a770cd498f24dbf64bd67b1https://doi.org/10.1046/j.1365-2796.2003.01215.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1A Structured Teaching and Self-management Program for Patients Receiving Oral Anticoagulation<SUBTITLE>A Randomized Controlled Trial</SUBTITLE>1999 · 353 citations
  2. 2Self-management of oral anticoagulation in the elderly: Rationale, design, baselines and oral anticoagulation control after one year of follow-up2007 · 32 citations
  3. 3Systematic review of studies of self-management of oral anticoagulation2004 · 63 citations
  4. 4Comparing Self-Management of Oral Anticoagulant Therapy with Clinic Management2005 · 211 citations
  5. 5Self-management program improves anticoagulation control and quality of life: a prospective randomized study2008 · 83 citations