SMART: Self-Management of Anticoagulation, a Randomised Trial [ISRCTN19313375]
<p style="text-align:justify;"> <b>Background:</b> Oral anticoagulation monitoring has traditionally taken place in secondary care because of the need for a laboratory blood test, the international normalised ratio (INR). The development of reliable near patient testing...
| Hoofdauteurs: | , , , , , , |
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| Formaat: | Journal article |
| Taal: | English |
| Gepubliceerd in: |
BioMed Central
2003
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| _version_ | 1826260240094461952 |
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| author | McCahon, D Fitzmaurice, D Murray, E Fuller, C Hobbs, R Allan, T Raftery, J |
| author_facet | McCahon, D Fitzmaurice, D Murray, E Fuller, C Hobbs, R Allan, T Raftery, J |
| author_sort | McCahon, D |
| collection | OXFORD |
| description | <p style="text-align:justify;"> <b>Background:</b> Oral anticoagulation monitoring has traditionally taken place in secondary care because of the need for a laboratory blood test, the international normalised ratio (INR). The development of reliable near patient testing (NPT) systems for INR estimation has facilitated devolution of testing to primary care. Patient self-management is a logical progression from the primary care model. This study will be the first to randomise non-selected patients in primary care, to either self-management or standard care.<br/><br/> <b>Method:</b> The study was a multi-centred randomised controlled trial with patients from 49 general practices recruited. Those suitable for inclusion were aged 18 or over, with a long term indication for oral anticoagulation, who had taken warfarin for at least six months. Patients randomised to the intervention arm attended at least two training sessions which were practice-based, 1 week apart. Each patient was assessed on their capability to undertake self management. If considered capable, they were given a near patient INR testing monitor, test strips and quality control material for home testing. Patients managed their own anticoagulation for a period of 12 months and performed their INR test every 2 weeks. Control patients continued with their pre-study care either attending hospital or practice based anticoagulant clinics.<br/><br/> <b>Discussion:</b> The methodology used in this trial will overcome concerns from previous trials of selection bias and relevance to the UK health service. The study will give a clearer understanding of the benefits of self-management in terms of clinical and cost effectiveness and patient preference. </p> |
| first_indexed | 2024-03-06T19:02:30Z |
| format | Journal article |
| id | oxford-uuid:14054f40-f56f-4a8c-9dfa-ec4e348b3c23 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T19:02:30Z |
| publishDate | 2003 |
| publisher | BioMed Central |
| record_format | dspace |
| spelling | oxford-uuid:14054f40-f56f-4a8c-9dfa-ec4e348b3c232022-03-26T10:17:15ZSMART: Self-Management of Anticoagulation, a Randomised Trial [ISRCTN19313375]Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:14054f40-f56f-4a8c-9dfa-ec4e348b3c23EnglishSymplectic Elements at OxfordBioMed Central2003McCahon, DFitzmaurice, DMurray, EFuller, CHobbs, RAllan, TRaftery, J <p style="text-align:justify;"> <b>Background:</b> Oral anticoagulation monitoring has traditionally taken place in secondary care because of the need for a laboratory blood test, the international normalised ratio (INR). The development of reliable near patient testing (NPT) systems for INR estimation has facilitated devolution of testing to primary care. Patient self-management is a logical progression from the primary care model. This study will be the first to randomise non-selected patients in primary care, to either self-management or standard care.<br/><br/> <b>Method:</b> The study was a multi-centred randomised controlled trial with patients from 49 general practices recruited. Those suitable for inclusion were aged 18 or over, with a long term indication for oral anticoagulation, who had taken warfarin for at least six months. Patients randomised to the intervention arm attended at least two training sessions which were practice-based, 1 week apart. Each patient was assessed on their capability to undertake self management. If considered capable, they were given a near patient INR testing monitor, test strips and quality control material for home testing. Patients managed their own anticoagulation for a period of 12 months and performed their INR test every 2 weeks. Control patients continued with their pre-study care either attending hospital or practice based anticoagulant clinics.<br/><br/> <b>Discussion:</b> The methodology used in this trial will overcome concerns from previous trials of selection bias and relevance to the UK health service. The study will give a clearer understanding of the benefits of self-management in terms of clinical and cost effectiveness and patient preference. </p> |
| spellingShingle | McCahon, D Fitzmaurice, D Murray, E Fuller, C Hobbs, R Allan, T Raftery, J SMART: Self-Management of Anticoagulation, a Randomised Trial [ISRCTN19313375] |
| title | SMART: Self-Management of Anticoagulation, a Randomised Trial [ISRCTN19313375] |
| title_full | SMART: Self-Management of Anticoagulation, a Randomised Trial [ISRCTN19313375] |
| title_fullStr | SMART: Self-Management of Anticoagulation, a Randomised Trial [ISRCTN19313375] |
| title_full_unstemmed | SMART: Self-Management of Anticoagulation, a Randomised Trial [ISRCTN19313375] |
| title_short | SMART: Self-Management of Anticoagulation, a Randomised Trial [ISRCTN19313375] |
| title_sort | smart self management of anticoagulation a randomised trial isrctn19313375 |
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