Results of a meta-analysis show that self-monitoring of oral anticoagulation by patients was superior to usual care in reducing thromboembolic events, with a risk reduction of 49% [1].
Self-management of anticoagulation, where patients not only self-test international normalized ratios (INR) themselves but actually were trained to self-adjust the warfarin dose based on these results, was superior to self-testing alone, where dose adjustments were made by physicians.
Rates of bleeding and mortality were similar between groups. The most striking reductions in risk were seen in patients younger than 55 years and in those taking anticoagulation because of a mechanical heart valve, the authors note, but there was no safety signal from this approach even among the very elderly.
Results of a meta-analysis show that self-monitoring of oral anticoagulation by patients was superior to usual care in reducing thromboembolic events, with a risk reduction of 49% [1].
Self-management of anticoagulation, where patients not only self-test international normalized ratios (INR) themselves but actually were trained to self-adjust the warfarin dose based on these results, was superior to self-testing alone, where dose adjustments were made by physicians.
Rates of bleeding and mortality were similar between groups. The most striking reductions in risk were seen in patients younger than 55 years and in those taking anticoagulation because of a mechanical heart valve, the authors note, but there was no safety signal from this approach even among the very elderly.