Effectiveness of a self-management programme in the treatment of antivitamin K oral anticoagulants. A feasibility study

Abstract

Background and objectivesTo compare the efficacy of a self-monitoring programme vs. the conventional method used before the intervention in maintaining the international normalised ratio in the therapeutic range in patients receiving oral anticoagulants, as well as complications, quality of life and the time invested in the tests. Materials and methodsPre-post pilot and feasibility study. The study included 15 patients over the age of 18 years who had been attending the monitoring programme for more than six months. In the pre phase, patients performed the tests and follow-up in the outpatient clinic. After conducting an individual training session with each patient to teach them how to perform venipuncture, use the coagulometer, manage dosing tables and subsequent follow-up from the virtual clinic, we compared the percentage of in-range INR tests, complications, quality of life, and the time invested in performing the tests pre- (conventional) and post-intervention (intervention for self-monitoring). ResultsThe percentage of INR tests in the therapeutic range was significantly higher in the post-phase than in the pre-phase (65.6% vs 37.8%, p < .001). Likewise, the incidence of both minor and serious complications decreased in the post-phase (20% vs. 0%, and 6.7% vs. 0%, respectively). Finally, all five dimensions of the quality of life questionnaire improved significantly, while the time invested decreased. ConclusionIn our experience, OAT self-monitoring is associated with a significant improvement in patient management, a reduction in the rate of complications, improved quality of life and timesaving.