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Post-conference session: Experience with patient self-management of oral anticoagulation

Abstract

Long-term oral anticoagulation requires careful patient monitoring in order to optimize results and to limit hemorrhagic or thromboembolic complications of treatment. For this reason, any improvement in anticoagulant control and management can be expected to have far-reaching consequences in extending longevity and decreasing complications in anticoagulated patients after heart valve surgery. Because one attractive means of improving anticoagulant management is to give patients a share of the responsibility, a program was designed to encourage patients to take an active role in monitoring their own prothrombin time (PT) and managing their own oral anticoagulation. During the period from August 1986 to February 1992, 600 patients requiring long-term anticoagulation, mainly after heart valve replacement, were trained to measure their own PT at the Cardiac Rehabilitation Center (Herz-Krauslauf-Klinik, Bad Berleburg, Germany) and to manage their own therapy: 216 patients could be followed with regard to their self-determined prothrombin times. The results were within the target range in 83.1% of the PT determinations (n=12,306 measurements) taken by the patients themselves. Neither major bleeding nor thromboembolic complications were observed in 205 patient-years of self-monitoring of PT and self-management of oral anticoagulation.

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References

  1. 1.

    Rose VL, Dermott SC, Murray BF, et al. Decentralized testing for prothrombin time and activated partial thrombo-plastin time using dry chemistry portable analyzer.Arch Pathol Lab Med 1993;117:611–617.

    PubMed  Google Scholar 

  2. 2.

    Bernardo A, Bernardo A, Leinberger R, Taborski U, Zerback R. Thromboplastinzeit-Selbstbestimmung mit Coagu-Chek System.Herz Kreislauf 1995;27:71–75.

    Google Scholar 

  3. 3.

    Tritschler W, Zerback R. CoaguChek PT Test. Ergibnisse der Erprobung eines neuen Systems zur Kontrolle der oralen Antikoagulanzientherapie (Dauertherapie mit Cumarinderivaten). Boehringer Mannheim GmbH, 68298, Mannheim, Germany.

  4. 4.

    Bernardo A, Taborski U, Wittstamm F-J. Arbeitsgemeinschaft Selbstkontrolle der Antkoagulation. Booklet published August, 1994 Bad Berleburg, Germany.

  5. 5.

    Jorgensen T. Anticoagulant monitoring in community care-A technology assessment. Danish Hospitals Institute, Copenhagen, 1992:2–55.

    Google Scholar 

  6. 6.

    Bernardo A, Halhuber C, Horstkotte D. Home prothrombin estimation. In: Butchart EG, Bodnar E, eds.Thrombosis, Embolism, and Bleeding. London: ICR Publishers; 1992: 325–330.

    Google Scholar 

  7. 7.

    White RH, McCurdy AS, von Marensdorff H, et al. Home prothrombin time monitoring after the initiation of warfarin therapy.Ann Intern Med 1989;11:730–737.

    Google Scholar 

  8. 8.

    Horstkotte D, Loogen F.Erwobene Herzklappenfehler, 1st ed. Wien. Urban & Sehwarzenberg, 1987:49–50.

    Google Scholar 

  9. 9.

    Forfar JC. A 7-year analysis of haemorrhage in patients on long-term anticoagulation treatment.Br Heart J 1979;42: 128–132.

    PubMed  Google Scholar 

  10. 10.

    Friedli B, Aerichide N, Grondin P, et al. Thromboembolic complications of heart valve prostheses.Am Heart J 1971; 81:702.

    PubMed  Google Scholar 

  11. 11.

    Roysten GR. Therapeutic control of anticoagulant treatment (letter).Br Int Med 1982;284:1871.

    Google Scholar 

Download references

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Correspondence to Angelika Bernardo M. D..

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Bernardo, A. Post-conference session: Experience with patient self-management of oral anticoagulation. J Thromb Thrombol 2, 321–325 (1996). https://doi.org/10.1007/BF01061920

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Key words

  • oral anticoagulation
  • self-management
  • PT monitor
  • quality of life