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Published on: February 28, 2012
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Self-management of warfarin therapy
Una Ørvim Sølvik1, Elisabeth Sellevoll Løkkebø2, Ann Helen Kristoffersen3
1Institutt for global helse og samfunnsmedisin Universitetet i Bergen.
Summary
Patient self-management of warfarin therapy showed similar time in therapeutic range (TTR) compared to conventional care. However, self-management significantly reduced extreme INR values, enhancing warfarin treatment safety.
Area of Science:
- Cardiology
- Pharmacology
- Patient Care
Background:
- International studies suggest warfarin self-management may lower mortality and thromboembolic risks compared to standard care.
- This study investigated the efficacy of patient self-management of warfarin in Norway.
Purpose of the Study:
- To train Norwegian patients in self-monitoring and self-management of warfarin therapy.
- To compare the outcomes of warfarin self-management with conventional therapy.
Main Methods:
- 23 patients trained in INR measurement (CoaguChek XS) and warfarin dosage adjustment over 27 weeks.
- Participants continued self-management for an additional 28 weeks.
- Time in therapeutic range (TTR) was calculated and compared between self-management and conventional therapy.
Main Results:
- No significant difference in average TTR between conventional therapy (70%) and self-management (75%, p=0.24).
- A significantly lower percentage of extreme INR values (<1.5 or >5.0) was observed during self-management (1.0%) compared to conventional therapy (6.8%, p<0.001).
Conclusions:
- Warfarin self-management in this Norwegian cohort did not significantly alter TTR compared to conventional therapy.
- Self-management demonstrated a significant reduction in extreme INR values, suggesting improved safety.
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