Key result
Ongoing PORTALS trial evaluates e-learning vs group training for anticoagulation self-management on TTR and complications.
Why the study?
eHealth applications may improve self-management of INR monitoring and anticoagulation therapy, but the optimal training implementation strategy and factors enhancing self-management are unclear.
Does e-learning training improve self-management of INR compared to face-to-face training or regular care in patients with VTE or AF?
Does e-learning training improve self-management of INR compared to face-to-face training or regular care in patients with VTE or AF?
The PORTALS study is designed to evaluate the optimal implementation strategy (e-learning vs face-to-face) for training patients in self-management of anticoagulation therapy.
eHealth may enhance anticoagulation self-management; leaves open need for RCTs before practice change.
BACKGROUND: For the monitoring of International Normalized Ratio (INR) values, venous thromboembolism (VTE) and atrial fibrillation (AF) patients can visit anticoagulation clinics, laboratories, or physicians for venous puncture. Point-of-care testing (POCT) made it possible for patients to monitor INR themselves (self-monitoring) and even self-adjust their medication dosage (self-dosage). Both skills are accepted as forms of self-management. eHealth applications can improve this self-management, resulting in better clinical outcomes. METHODS: Our study, called PORTALS, aims at identifying the optimal implementation strategy of training to improve self-management and explore factors that enhance good self-management skills. In addition, the relationship between the implementation strategy of training, clinical outcomes, and individual characteristics will be investigated. Of the 247 recruited participants, 110 chose to continue with regular care. 137 patients have been randomly divided in subgroups and compared using a parallel cohort design: one group will be trained and educated by e-learning, and the other group will receive face-to-face group training. DISCUSSION: More insight in factors that enhance good self-management will help to improve clinical outcomes and patient satisfaction on anticoagulation therapy. Our study will provide practical insights and knowledge of eHealth in daily practice and of the importance of education on the adoption of self-management. We expect the self-management program including training to help patients to better manage their own INR values and medication use, thereby increasing health status and diminishing thromboembolic events and hospitalisation. TRIAL REGISTRATION: The Netherlands National Trial Register, number NTR3947 .
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Talboom-Kamp et al. (2017) studied Venous thromboembolism and atrial fibrillation requiring anticoagulant therapy (n=247). e-learning and group training for anticoagulation self-management vs. Usual care was evaluated on Health status, expressed by Time in Therapeutic Range (TTR) and severe complications (bleedings and thromboembolic events). The PORTALS study is an ongoing trial designed to evaluate the effect of e-learning versus group training for anticoagulation self-management on Time in Therapeutic Range and complications over 18 months.
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