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

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


Embedded ImageDesign:

randomised controlled trial (RCT).

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded (outcome assessors of complications).

Embedded ImageFollow up period:

median 11.8 months.

Embedded ImageSetting:

a university affiliated hospital in Barcelona, Spain.

Embedded ImagePatients:

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

Embedded ImageIntervention:

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. …

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  • For correspondence: Dr J C Souto, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.

  • Source of funding: in part, Roche Diagnostic SL.