| Summary: | <h4>Background</h4> <p>Trials show that oral anticoagulation therapy (OAT) substantially reduces thromboembolic events without an increase in major haemorrhagic events, but it is not known whether these results translate into routine practice.</p> <h4>Aim</h4> <p>To estimate the current levels of control and adverse events in patients self-monitoring OAT, explore the factors that predict success, and determine whether the level of side effects reported from randomised controlled trials are translated to a non-selected population.</p> <h4>Design and setting</h4> <p>Prospective cohort study in the UK.</p> <h4>Method</h4> <p>Participants were aged ≥18 years and registered with a GP. Main outcomes were the proportion of participants, over 12 months, who were still self-monitoring, had not experienced adverse events, and had achieved >80% of time in therapeutic range (TTR).</p> <h4>Results</h4> <p>In total, 296 participants were recruited; their median age was 61 years and 55.1% were male. Participants were predominately professional or held a university qualification (82.7%). At 12 months, 267 (90.2%) were still self-monitoring. Mean TTR was 75.3% (standard deviation 16.9).Six serious and two minor adverse events were reported by GPs. Only 45.9% of participants received any in-person training at the outset. Increased age (P= 0.027), general wellbeing (EQ-5D visual score, P= 0.020), and lower target international normalised range (INR, P= 0.032) were all associated with high (>80% TTR) levels of control.</p> <h4>Conclusion</h4> <p>The findings show that, even with little training, people on OAT can successfully self-monitor, and even self-manage, their INR. TTR was shown to improve with age. However, widespread use of self-monitoring of INR may be limited by the initial costs, as well as a lack of training and support at the outset.</p>
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