[How can we improve long-term anticoagulation?]

Oral anticoagulation is sometimes unjustly referred to as a particularly difficult form of antithrombotic therapy. Apparent failures of this treatment may be caused by insufficient information on the part of either the physician or the patient himself, poor standardization of laboratory tests and/or inadequate dosage of vitamin K antagonists. Specialized centers for treatment of thrombosis have done pioneer work in standardizing and evaluating oral anticoagulant treatment with respect to various indications. Based on this experience, optimum long-term anticoagulant therapy is today possible even in a small hospital or in general medical practice, provided that the pharmacological peculiarities of vitamin K antagonists and international developments concerning standardization of the prothrombin time (Quick test) and its modifications (International Normalized Ratio, INR) are taken into consideration. Regular internal and external quality control of laboratory tests for monitoring of oral anticoagulation is of the utmost importance.