Implications for practice and research

• For suitable patients self-monitoring or self-managing enhances the quality of oral anticoagulation therapy.

• Self-monitoring and self-managing patients experience greater time in therapeutic range with the associated decrease in thromboembolic events.

• Future research should focus on establishing the factors affecting the uptake of self-monitoring and self-managing of oral anticoagulation.

Context

There are 950 000 people in the UK taking oral anticoagulants in the form of vitamin K antagonists such as warfarin1 for prevention of thromboembolic events associated with conditions including atrial fibrillation (AF) and prosthetic heart valves. With the current ongoing rise in AF diagnosis, this number has the potential to rise further.

Vitamin K antagonists have a narrow therapeutic window and in order to maintain the effectiveness …