[Patient self-monitoring of oral anticoagulation with CoaguChek].
We investigated the feasibility, quality and safety of patient self-control of oral anticoagulation. The patients were selected by their physicians on the basis of criteria such as compliance, skills and motivation. After theoretical and practical training they self-monitored and self-adjusted their anticoagulant dosage for 6 months by weekly self-measurement of their INR values using a capillary whole blood prothrombin time monitor (CoaguChek). Venous INR measurements once a month served as quality control. There were 51 study participants, who performed a median 5 INR measurements per month. 75.8% of all registered INR values were within the recommended individual INR target ranges. The coefficient of correlation between capillary (y) and venous (x) INR values was r = 0.87 (regression analysis y = 1.0 x -0.2). The concordance of capillary and venous INR values was 80% with respect to the individual INR target ranges. There were 5 minor bleeding episodes and no overt thromboembolic recurrences during the study period. In conclusion, the study demonstrated that patient self-control of oral anticoagulation is feasible and achieves a high percentage of INR values within the recommended target ranges. Therefore, self-control of oral anticoagulation can be offered to skilled and motivated patients as an alternative to physician-guided antiocogulation. However, specific training of these selected patients is necessary.
Caliezi
C
C
Hämatologisches Zentrallabor, Inselspital, Universitätsspital Bern.
Waber
M
M
Pfiffner
D
D
Saner
H
H
Lämmle
B
B
Wuillemin
W A
WA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D019934:International Normalized Ratio; D008134:Long-Term Care; D008297:Male; D008875:Middle Aged; D018670:Monitoring, Ambulatory / Q000295:instrumentation*; D010349:Patient Compliance; D011237:Predictive Value of Tests; D011517:Prothrombin Time; D012648:Self Care / Q000295:instrumentation*; D019851:Thrombophilia / Q000097:blood / Q000188:drug therapy* / Q000209:etiology
D000925:Anticoagulants