Self-monitoring of oral anticoagulation: does it work outside trial conditions?
2009

Self-Monitoring of Oral Anticoagulation: Does It Work Outside Trial Conditions?

Sample size: 318 publication Evidence: moderate

Author Information

Author(s): C Gardiner, I Longair, M A Pescott, H Erwin, J Hills, S J Machin, H Cohen

Primary Institution: University College London Hospitals

Hypothesis

Can patient self-monitoring of oral anticoagulation therapy be a viable alternative to regular hospital clinic attendance from the start of treatment?

Conclusion

Self-monitoring patients showed better anticoagulant control and higher uptake compared to previous studies.

Supporting Evidence

  • 84 out of 318 patients elected to self-monitor their anticoagulation.
  • Self-monitoring patients had a median time in therapeutic range of 71%, compared to 60% for routine care.
  • Self-monitoring patients spent significantly less time outside critical INR limits.

Takeaway

Some patients can check their own blood levels for blood thinners at home, and they do just as well as those who go to the hospital.

Methodology

A prospective closed cohort audit assessing 318 patients referred for oral anticoagulation, with eligibility for self-monitoring determined by established criteria.

Potential Biases

The study did not randomize participants, which could introduce selection bias.

Limitations

No randomization was performed, and the self-monitoring patients were younger than those in routine care, which may affect outcomes.

Participant Demographics

{"self_monitoring":{"male":43,"female":41,"median_age":58},"routine_care":{"male":54,"female":51,"median_age":68}}

Statistical Information

P-Value

0.003

Confidence Interval

95% CI 69.9 to 80.6

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1136/jcp.2008.059634

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