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Evid Based Nurs 8:87 doi:10.1136/ebn.8.3.87
  • Treatment

Patient self management of anticoagulants resulted in fewer major complications than clinic-based management


 
 Q Is patient self management of oral anticoagulants as efficacious and safe as management in an anticoagulation clinic?

METHODS

GraphicDesign:

randomised controlled trial (RCT).

GraphicAllocation:

concealed.

GraphicBlinding:

blinded (outcome assessors of complications).

GraphicFollow up period:

median 11.8 months.

GraphicSetting:

a university affiliated hospital in Barcelona, Spain.

GraphicPatients:

737 ambulatory patients ⩾18 years of age who had received anticoagulant treatment for ⩾3 months.

GraphicIntervention:

self management (n = 368) or clinic-based management (n = 369) of oral anticoagulant treatment with acenocoumarol. Self management training included a small group, education programme delivered by a specialist nurse in two 2-hour sessions. Content included use of a coagulometer, interpretation of international normalised ratios (INRs), and adjustment of doses. Patients tested their INRs once a week using the portable CoaguChek S coagulometer (Roche Diagnostics, Germany) and determined the appropriate anticoagulant dose …

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