An evidence-based review and guidelines for patient self-testing and management of oral anticoagulation.
There is a limited evidence base for self-testing and -management for oral anticoagulation management. Available data suggest that these are credible models for a significant minority of patients if underpinned by structured training and follow-up. The guidelines presented are necessarily consensual and outline procedures for patient selection, training, product procurement, product maintenance, quality assurance procedures, dosage adjustment and clinical supervision. The cost-effectiveness of these models remains to be elucidated within the UK. Further data on both health economic and clinical outcomes are required from UK based studies before widespread implementation of self-testing and management can be recommended on a wider scale.
Fitzmaurice
D A
DA
Department of Primary Care and General Practice, The Medical School, The University of Birmingham, Birmingham, UK. d.a.fitzmaurice@bham.ac.uk
Gardiner
C
C
Kitchen
S
S
Mackie
I
I
Murray
E T
ET
Machin
S J
SJ
D000925:Anticoagulants / Q000627:therapeutic use*; D006801:Humans; D019934:International Normalized Ratio; D017410:Practice Guidelines as Topic; D011785:Quality Assurance, Health Care; D016032:Randomized Controlled Trials as Topic; D012646:Self Administration; D013923:Thromboembolism / Q000097:blood / Q000517:prevention & control*; D006113:United Kingdom; D014859:Warfarin / Q000627:therapeutic use*
D000925:Anticoagulants; D014859:Warfarin