Why the study?
Does patient self-management of oral anticoagulation improve outcomes compared to specialized anticoagulant clinics?
Does patient self-management of oral anticoagulation improve outcomes compared to specialized anticoagulant clinics?
Patient self-management of oral anticoagulation is a viable and effective alternative to specialized clinics for selected patients, though optimal protocols and cost-effectiveness require further clarification.
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May support self-management in selected patients; leaves open optimal protocols and cost-effectiveness.
Patient self-management of oral anticoagulation is now widely practised in Germany and the USA. There are three different home-testing monitors available in the UK which are all reliable in terms of accuracy and reproducibility of results. Selected patients can be trained to perform their own International Normalized Ratio (INR) testing and dosing, with outcomes as good if not better than those from specialized anticoagulant clinics. Consensus on the frequency of testing and what quality control should be deployed is lacking. The cost-effectiveness in the UK is unproven.
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Bhavnani et al. (2002) studied this question.
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