Is patient self-monitoring (including self-testing and selfmanagement) of oral anticoagulation therapy safe, efficacious and cost-effective?
Myles S
Record ID 32011000039
English
Authors' recommendations:
Recent systematic reviews and meta analyses indicate that for selected and well trained patients, self-monitoring of oralanticoagulation therapy (OAT) is safe, more effective than usual care provided by family doctors and as effective as monitoring undertaken in specialised anticoagulation clinics and laboratories.These reviews should, however, be interpreted with caution. Differences in the trial settings, methods of patient self-monitoring and usual care comparators, alongside uncertainties regarding the nature and robustness of the quality assurance mechanisms underpinning the evidence may alter the magnitude of the effect estimates and their generalisability to UK care settings.Two recent economic models concluded that patient self-monitoring and testing of OAT was not cost effective compared toclinic-based usual care. Neither model was sufficiently transparent to enable the results to be generalised to the Scottish care setting. Scottish decision makers should therefore compare the annual costs of self-monitoring and training to the potential avoided costs from clinic-based usual care to judge cost effectiveness in their own settings.To operate any safe anticoagulation point of care test, robust quality assessment is essential.
Details
Project Status:
Completed
Year Published:
2009
URL for published report:
http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicines/earlier_evidence_notes/evidence_note_27.aspx
URL for additional information:
http://www.healthcareimprovementscotland.org/our_work/technologies_and_medicines/shtg_-_evidence_notes/evidence_note_50.aspx
English language abstract:
An English language summary is available
Publication Type:
Not Assigned
Country:
Scotland
MeSH Terms
- Administration, Oral
- Point-of-Care Systems
- Self Care
Contact
Organisation Name:
Quality Improvement Scotland
Contact Address:
Delta House, 50 West Nile Street Glasgow G1 2NP Scotland United Kingdom Tel: +44 141 225 6988; Fax: +44 141 221 3262
Contact Name:
shtg.hcis@nhs.net
Contact Email:
shtg.hcis@nhs.net
Copyright:
<p>NHS Quality Improvement Scotland (NHS QIS)</p>
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