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
Design:
randomised controlled trial (RCT).
Allocation:
concealed.
Blinding:
blinded (outcome assessors of complications).
Follow up period:
median 11.8 months.
Setting:
a university affiliated hospital in Barcelona, Spain.
Patients:
737 ambulatory patients ⩾18 years of age who had received anticoagulant treatment for ⩾3 months.
Intervention:
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 …
