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Published on: February 28, 2012

Oral anticoagulation therapy in children: successfully controlled by self-management

Thomas Decker Christensen1, Niels Trolle Andersen, Marianne Maegaard

  • 1Department of Cardiothoracic and Vascular Surgery and Clinical Institute, Skejby Sygehus, Aarhus University Hospital, Denmark. tdc@ki.au.dk

The Heart Surgery Forum
|September 30, 2004
PubMed

Insights

Self-management of oral anticoagulation therapy is safe and effective for children with congenital heart disease. This approach allows for good treatment quality, with patients achieving therapeutic international normalized ratio (INR) targets.

Area of Science:

  • Pediatric Cardiology
  • Pharmacology
  • Health Management

Background:

  • Children with congenital heart disease on oral anticoagulation face challenges like fluctuating INR, frequent visits, and venipuncture pain.
  • Self-management is hypothesized to improve oral anticoagulation therapy control in this pediatric population.

Purpose of the Study:

  • To assess the treatment quality of self-managed oral anticoagulation therapy in children with congenital heart disease.
  • To determine the proportion of time patients remained within their therapeutic international normalized ratio (INR) target range.

Main Methods:

  • Twenty-two children with congenital heart disease were trained in home INR monitoring and coumarin dosage adjustment.
  • Patients were monitored weekly, with a therapeutic INR range of +/-0.5.
  • Indications included mechanical heart valves (n=16) and total cavopulmonary connection (n=6).

Main Results:

  • Patients spent a median of 73.1% of the observation time within the therapeutic INR range.
  • The mean observation period was 3.6 years.
  • No thromboembolic or bleeding complications requiring medical intervention occurred.

Conclusions:

  • Self-management of oral anticoagulation therapy is a safe and effective treatment strategy for selected children with congenital heart disease.
  • This approach ensures good quality of treatment and adherence to therapeutic INR targets.
Abstract

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