Self-testing can double efficacy of blood-thinning therapy

The prevalence of conditions such as cardiac arrythmia, blood clots, and artificial heart valves means that about 3 million people in the U.S. are eligible for blood-thinning therapy. This treatment, known as oral anticoagulation therapy, requires frequent blood monitoring and regulation of dosage in order to prevent excessive or inadequate blood thinning. Typically, such monitoring means that patients must make frequent visits to the clinic. However, a study just published in The Lancet has reported that patients who self-monitor their oral-anticoagulation therapy cut their risk of typical complications in half.

A team led by a clinical epidemiologist at Oxford University studied the efficacy of self-monitoring which means that the patients test their blood s rate of coagulation, rather than having this done by a physician. Researchers analyzed patient data from 11 randomized trials, comparing self-monitoring of oral anticoagulation therapy with conventional care. Most significantly, the researchers found that self-monitoring reduced the risk of excessive clotting by nearly half, although the rate of bleeding complications was similar in both groups. Self-monitoring was effective in all age-groups, although the benefits varied: Individuals younger than 55 years benefited a surprising amount, reducing their risk of excessive clotting by two-thirds, while very elderly patients mortality was actually lowered by the practice.

The results of their analysis have led the researchers to conclude that self-monitoring and self-management of oral anti-coagulation is a safe option for suitable patients of all ages. ACSH s Dr. Elizabeth Whelan agrees with the researchers conclusion, but points out that the patient must understand the various contraindications associated with a blood-thinning drug, as well as the dose-management procedure. If a patient can do that, she says, self-monitoring sounds like a beneficial option. ACSH s Dr. Gilbert Ross is slightly more cautious in his assessment of the study: This is promising, he says, but the findings need further corroboration before clinical practice changes.