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Patient self-management of oral anticoagulation and external quality assessment procedures

E T Murray1, D P Kitchen, S Kitchen

  • 1Department of Primary Care and General Practice, The Medical School, University of Birmingham, Edgbaston, Birmingham, UK. e.t.murray@bham.ac.uk

British Journal of Haematology
|August 22, 2003
PubMed

Insights

Patients can effectively perform external quality assessment (EQA) for self-managed oral anticoagulation. Their results using the UK National External Quality Assessment Scheme (NEQAS) closely matched those of healthcare professionals.

Area of Science:

  • Clinical Chemistry
  • Pharmacology
  • Patient Self-Management

Background:

  • External quality assessment (EQA) for patient self-management (PSM) of oral anticoagulation is debated.
  • Previous studies have not fully evaluated patient EQA competence.

Purpose of the Study:

  • To compare the efficacy of patient versus healthcare professional EQA procedures in PSM of oral anticoagulation.
  • To assess patient competence in performing EQA using the UK National External Quality Assessment Scheme (NEQAS).

Main Methods:

  • 23 patients on PSM using Coaguchek performed EQA twice unsupervised at home and twice supervised in practice.
  • Patient EQA results were compared with 75 healthcare professionals using Coaguchek S and NEQAS.
  • International Normalized Ratio (INR) percentage time in range for the PSM group was calculated.

Main Results:

  • The PSM group achieved 74% time in therapeutic INR range.
  • No significant difference was found between patient and professional median NEQAS results.
  • Patients demonstrated competence, with coefficients of variation between 5.4% and 22.3%.

Conclusions:

  • Patients can competently perform EQA for oral anticoagulation self-management.
  • Patient and professional EQA results show good agreement, supporting PSM efficacy.
  • Further research is needed to link EQA precision to treatment stability in PSM.

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