Cohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community.
<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> &l...
| Main Authors: | , , , , , |
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| Format: | Journal article |
| Language: | English |
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Royal College of General Practitioners
2015
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| _version_ | 1797070299117649920 |
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| author | Ward, A Tompson, A Fitzmaurice, D Sutton, S Perera, R Heneghan, C |
| author_facet | Ward, A Tompson, A Fitzmaurice, D Sutton, S Perera, R Heneghan, C |
| author_sort | Ward, A |
| collection | OXFORD |
| description | <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> |
| first_indexed | 2024-03-06T22:36:49Z |
| format | Journal article |
| id | oxford-uuid:5a2f27ac-4c5f-42b4-8072-1863cb05b7fc |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-06T22:36:49Z |
| publishDate | 2015 |
| publisher | Royal College of General Practitioners |
| record_format | dspace |
| spelling | oxford-uuid:5a2f27ac-4c5f-42b4-8072-1863cb05b7fc2022-03-26T17:14:17ZCohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community.Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:5a2f27ac-4c5f-42b4-8072-1863cb05b7fcEnglishSymplectic Elements at OxfordRoyal College of General Practitioners2015Ward, ATompson, AFitzmaurice, DSutton, SPerera, RHeneghan, C <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> |
| spellingShingle | Ward, A Tompson, A Fitzmaurice, D Sutton, S Perera, R Heneghan, C Cohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community. |
| title | Cohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community. |
| title_full | Cohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community. |
| title_fullStr | Cohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community. |
| title_full_unstemmed | Cohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community. |
| title_short | Cohort study of Anticoagulation Self-Monitoring (CASM): a prospective study of its effectiveness in the community. |
| title_sort | cohort study of anticoagulation self monitoring casm a prospective study of its effectiveness in the community |
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