[Self-monitoring of oral coagulation: for which patients?]

Oral anticoagulant treatment with vitamin K antagonists (VKA) is prescribed to an increasing number of patients. These drugs are,however, one of the leading causes of iatrogenic disease. It is essential to monitor the intensity of anticoagulation very closely, by a biological measure (INR, international normalized ratio),to minimize the frequency of thrombotic and hemorrhagic events that may occur in the case of insufficient or excessive anticoagulation. Current methods of monitoring INR can be improved.Self-testing of INR and self-monitoring of oral coagulation treatment offer advantages over more conventional approaches. This self-testing can be performed by most patients capable of living alone, regardless of their social status or educational level. Despite the existence of very reliable self-testing devices, France is very far behind in the use of these instruments that allow management and improve the morbidity and mortality inherent in anticoagulant treatment.