[Self testing and self management of oral anticoagulants with warfarin]

Oral anticoagulation therapy has been shown to be effective for the prevention and treatment of thromboembolic events in various clinical settings. Since the biological effects of coumarin derivatives are extremely variable, both inter-individually and intra-individually, under-dosage as well as over-dosage are frequently observed, and can only be prevented by frequent laboratory testing of anticoagulation intensity, and consecutive dose adjustment if necessary. Several studies have shown that self-testing and self-management of oral anticoagulation therapy might improve the quality of anticoagulation, and reduce the incidences of bleeding complications and thromboembolic events. Recently, portable INR-monitors are available, which allow more convenient and thus more frequent control of oral anticoagulation. This review presents several aspects and current studies on the results of patient self-testing and self-management of oral anticoagulation therapy.