Review: self testing and self management increase the benefits and reduce the harms of anticoagulant therapy
Q In patients receiving oral anticoagulant therapy, what is the relative effectiveness of self testing and self management compared with standard monitoring?
Medline, EMBASE/Excerpta Medica, and CINAHL (up to 2005); Cochrane Central Register of Controlled Trials; Cochrane Library (Issue 2, 2005); UK National Research Register; Trials Central; bibliographies of retrieved studies; manufacturers of home monitors; and experts.
Study selection and assessment:
randomised controlled trials (RCTs) that compared self testing (only) or self management (testing and dose adjustment) with management by healthcare professionals (control group) in adults or children receiving oral anticoagulation therapy for any indication. 14 RCTs (n = 3049, mean age 42–75 y) met the selection criteria. Management of the control group was provided by primary care physicians in 8 RCTs and by specialised anticoagulation clinics in 6 RCTs. Duration of the studies ranged from 2 to 24 months. Quality of individual trials was assessed based …