Patients who self-monitor warfarin halve stroke risk

Patients who self-monitor their warfarin therapy halve their risk of DVT, stroke and MI, research suggests.

Stroke: risk was lowered with self adjusted anticoagulant dosing

A University of Oxford team reported a 49% reduction in thromboembolic events in patients who monitored and adjusted anticoagulant dosing, compared with standard care

Researchers said the finding showed self-management of oral coagulation was safe for suitable patients of all ages.

Researchers led by Dr Carl Heneghan analysed data from 11 trials including 6,417 participants to give more evidence of the benefits.

They estimated the effect of self-monitoring on risk of first thromboembolic event, major bleeding or death.

Researchers also examined effects among subgroups such as the elderly, AF patients and those with a mechanical heart valve.

Patients who self-monitored had a similar rate of bleeding complications and mortality as those given standard care.

Self-monitoring showed a ‘striking' two-thirds reduction in thromboembolic risk in people under 55, the researchers said. Just 21 patients needed to self-monitor for one year to prevent one thromboembolic event. By comparison, 63 patients on daily statin therapy for five years are needed to prevent one MI, researchers said.

In very elderly people at high risk of major bleeding, results suggested that self-monitoring could lower mortality while not increasing complications.

Authors concluded: 'Self-monitoring and self-management of oral coagulation is a safe option for suitable patients of all ages. Patients should also be offered the option to self-manage their disease with suitable health care support as back-up.’

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