Long-term patient follow-up because of oral anticoagulation

Hippokratia 2004, 8(1):35-39

IA Voyiatzis, E Kambitsi, T Karamitsos, M Kachrimanidou, IM Vogiatzis
Cardiology Dpt, General Hospital of Veria, Veria, Greece
Haematology Dpt, General Hospital of Veria, Veria, Greece


Abstract

Introduction: The management of oral anticoagulation is fraught with difficulties. The aim of the study was the evaluation of the ability, safety and efficacy of patients to self- monitor and self-adjust the dose of their oral anticoagulants.
Methods: We studied 12 patients (5 men – 7 women, 59.9± 11.99 years) with guides to self-monitor the Prothrombin Time (PT) at hospital Laboratory and self – adjust the dose of their anticoagulant (Group A) compared with 15 control patients (7 men – 8 women, 51.9±5.06 years) followed the classic methods of follow up (Group B).
Results: Group A patients monitored their PTs significantly lesser times than Group B patients (8.17±3.83 / 15.7±4.83 per patient, p: 0.02) with fewer dosage changes than control patients (4.91±1.05 / 8.46±1.50, p < 0.05). The PTs in group A patients were in recommended therapeutic range in 82.3 % of the determinations compared with 65.7 % in group B patients (p < 0.001). Group A patients made 3.1 % incorrect dosage changes and group B 3.9 % (p: 0.1). There were no significant differences in complications between the patients of the two groups.
Conclusion: Patients can successfully measure their PT, adjust their anticoagulant dosage (like diabetics their insulin dosage) and achieve an acceptable therapeutic effectiveness.