Implications for practice and research

• Patient self-testing and self-management programmes that augment education and telehealth approaches present a safe, sustainable and acceptable model of care for individuals with routine anticoagulation monitoring and management needs.

• There is need for further research of patient self-testing and self-management programmes that addresses patient selection and building patient confidence.

Context

Warfarin remains a key agent for thromboprophylaxis. However, it is not without complications. A narrow therapeutic range translates to a fine balance between thrombosis and bleeding. Given warfarin’s sometimes unpredictable nature, achieving quality anticoagulation can be challenging. Regular monitoring and careful titration of therapy are required in accordance with a patient’s international normalised ratio (INR). For the majority of patients, this means visits for regular venous blood sampling which can be costly, inconvenient and impact on a patient’s quality of life. Evidence suggests that patient …