[Patient self-monitoring of oral anticoagulation with CoaguChek]

We investigated the feasibility, quality and safety of patient self-control of oral anticoagulation. The patients were selected by their physicians on the basis of criteria such as compliance, skills and motivation. After theoretical and practical training they self-monitored and self-adjusted their anticoagulant dosage for 6 months by weekly self-measurement of their INR values using a capillary whole blood prothrombin time monitor (CoaguChek). Venous INR measurements once a month served as quality control. There were 51 study participants, who performed a median 5 INR measurements per month. 75.8% of all registered INR values were within the recommended individual INR target ranges. The coefficient of correlation between capillary (y) and venous (x) INR values was r = 0.87 (regression analysis y = 1.0 x -0.2). The concordance of capillary and venous INR values was 80% with respect to the individual INR target ranges. There were 5 minor bleeding episodes and no overt thromboembolic recurrences during the study period. In conclusion, the study demonstrated that patient self-control of oral anticoagulation is feasible and achieves a high percentage of INR values within the recommended target ranges. Therefore, self-control of oral anticoagulation can be offered to skilled and motivated patients as an alternative to physician-guided antiocogulation. However, specific training of these selected patients is necessary.