Self-testing and self-management of warfarin anticoagulation therapy in geriatric patients

Although anticoagulation therapy with warfarin is necessary for many patients, the burden of frequent clinic visits for monitoring of therapy can pose a potential problem for some older adults. As self-monitoring of warfarin therapy has grown in popularity, a recent meta-analysis has reviewed data relating to self-testing and self-management of anticoagulation therapy. This same study also analyzed outcomes in the elderly, finding a potential benefit for self-monitoring in this population. This potential benefit, combined with the difficulties many elderly patients have attending clinic visits because of a lack of mobility or unavailability of transportation, makes self-monitoring of warfarin a viable option for carefully selected elderly patients. Pharmacists can play a vital role in educating patients about self-monitoring of oral anticoagulation therapy as well as identifying those elderly patients who are good candidates for its use.