title: Self-management of warfarin therapy.
abstract: BACKGROUND
  Clinical studies from other countries show that self-management of warfarin therapy may reduce the risk of mortality, thromboembolism and complications when compared to conventional therapy. The purpose of this study was to train patients in self-management and compare the results with conventional therapy in Norway.
  
  
  METHODS
  A total of 23 patients who had previously been given conventional therapy by their GPs were instructed in how to measure INR (using the CoaguChek XS device) and administer warfarin dosage through a structured training programme over the course of 27 weeks. The participants continued with self-management for a further 28 weeks after the end of the training period. The time in the therapeutic range (TTR, measured as a percentage) was calculated and the TTR for conventional therapy and self-management were compared.
  
  
  RESULTS
  No significant difference in average TTR was found when comparing conventional therapy (70% (95% confidence interval (CI) 62-78)) with the self-management period (75% (95% CI 69-81, p = 0.24)). The percentage of extreme INR values (< 1.5 or > 5.0) was higher during conventional therapy than during self-management (6.8% vs. 1.0%, p < 0.001).
  
  
  CONCLUSIONS
  No significant difference in TTR was found when comparing self-management and conventional warfarin therapy in our study, but for self-management there was a lower percentage of extreme INR values compared to conventional warfarin therapy.
authors.affiliation: Institutt for global helse og samfunnsmedisin Universitetet i Bergen.
authors.forename: Una Ørvim
authors.initials: UØ
authors.lastname: Sølvik
authors.affiliation: Norsk kvalitetsforbedring av laboratorievirksomhet utenfor sykehus (Noklus) Haraldsplass diakonale sykehus.
authors.forename: Elisabeth Sellevoll
authors.initials: ES
authors.lastname: Løkkebø
authors.affiliation: Norsk kvalitetsforbedring av laboratorievirksomhet utenfor sykehus (Noklus) Haraldsplass diakonale sykehus og Laboratorium for klinisk biokjemi Haukeland universitetssykehus.
authors.forename: Ann Helen
authors.initials: AH
authors.lastname: Kristoffersen
authors.affiliation: Norsk kvalitetsforbedring av laboratorievirksomhet utenfor sykehus (Noklus) Haraldsplass diakonale sykehus.
authors.forename: Anne Vegard
authors.initials: AV
authors.lastname: Stavelin
authors.affiliation: Norsk kvalitetsforbedring av laboratorievirksomhet utenfor sykehus (Noklus) Haraldsplass diakonale sykehus og Laboratorium for klinisk biokjemi Haukeland universitetssykehus.
authors.forename: Stein
authors.initials: S
authors.lastname: Binder
authors.affiliation: Institutt for global helse og samfunnsmedisin Universitetet i Bergen og Norsk kvalitetsforbedring av laboratorievirksomhet utenfor sykehus (Noklus) Haraldsplass diakonale sykehus og Laboratorium for klinisk biokjemi Haukeland universitetssykehus.
authors.forename: Sverre
authors.initials: S
authors.lastname: Sandberg
mesh_terms: D000328:Adult; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000517:prevention & control; D016903:Drug Monitoring; D005260:Female; D006350:Heart Valve Prosthesis; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D009664:Norway; D010353:Patient Education as Topic; D019095:Point-of-Care Systems; D012646:Self Administration; D012648:Self Care; D016896:Treatment Outcome; D054556:Venous Thromboembolism / Q000517:prevention & control; D014859:Warfarin / Q000008:administration & dosage* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin