Self-testing and self-management of oral anticoagulation therapy in children

2011 ◽  
Vol 106 (09) ◽  
pp. 391-397 ◽  
Author(s):  
Torben Larsen ◽  
Vibeke Hjortdal ◽  
Thomas Christensen
Keyword(s):  
Children And Adolescents ◽  
Oral Anticoagulation ◽  
Treatment Options ◽  
Anticoagulation Therapy ◽  
Self Management ◽  
Target Range ◽  
Oral Anticoagulation Therapy ◽  
Clinical Endpoints ◽  
Conventional Management ◽  
Self Testing

SummaryChildren and adolescents on oral anticoagulation therapy (OAT) present special challenges in terms of rapid fluctuations in International Normalised Ratio (INR) values, interruption in daily life due to frequent hospital/doctor visits, and difficulties and pain in the performance of venepuncture. Optimised management of OAT improves the quality of treatment, potentially accomplished by new methods such as patient self-testing (PST) and patient self-management (PSM). A review was performed, identifying 11 trials with children and adolescents. All studies had different methodological problems, predominantly by being non-randomised trials. A total of 284 patients were included with a mean follow-up of 22 months, finding a time within therapeutic INR target range between 63% and 84%. The coagulometers used for estimating the INR values were found to have sufficient precision and accuracy for clinical use, but external quality control is probably advisable. It can be concluded that PST and PSM are at least as good treatment options as conventional management in highly selected children. Larger studies, preferably randomised, controlled trials using clinical endpoints, are obviously needed in order to elucidate whether these new regimens of treatment are superior to conventional management of oral anticoagulation therapy.

scholarly journals Does self-management of oral anticoagulation therapy improve quality of life and anxiety?

2010 ◽  
Vol 28 (2) ◽  
pp. 134-140 ◽  
Author(s):  
D. McCahon ◽  
E. T. Murray ◽  
K. Murray ◽  
R. L. Holder ◽  
D. A. Fitzmaurice
Keyword(s):  
Quality Of Life ◽  
Oral Anticoagulation ◽  
Anticoagulation Therapy ◽  
Self Management ◽  
Improve Quality ◽  
Oral Anticoagulation Therapy

Implementation of SintromacWeb®, a new internet-based tool for oral anticoagulation therapy telecontrol: Study on system consistency and patient satisfaction

2010 ◽  
Vol 103 (05) ◽  
pp. 1091-1101 ◽  
Author(s):  
Yolanda Mira ◽  
María Teresa Contreras ◽  
Cristina Aguado ◽  
José Antonio Aznar ◽  
Fernando Ferrando
Keyword(s):  
Patient Satisfaction ◽  
Oral Anticoagulation ◽  
Point Of Care ◽  
Anticoagulation Therapy ◽  
International Normalized Ratio ◽  
Final Visit ◽  
Normal Range ◽  
Oral Anticoagulation Therapy ◽  
Self Testing ◽  
Anticoagulated Patients

SummaryMost computer- or internet-assisted systems for oral anticoagulation therapy (OAT) telemanagement have limitations when it comes to implementation within a healthcare center. It was the objective of this study to evaluate convenience and patient satisfaction with the use of SintromacWeb→, a new OAT telecontrol system, compared with the conventional control. SintromacWeb® consists of a point-of-care device for patient international normalized ratio (INR) self-testing and software that allows internet mediated interaction with physicians. Patients initiated the use of SintromacWeb→ and were followed up during a three-month period. A score-based questionnaire was completed in three controlled visits, and data were subsequently analysed. A total of 102 patients were enrolled. At first visit, 55.7% of the patients had their INR within normal range, and 64.9% at the final visit. Internal consistency of the questionnaire was good (Cronbach‘s α: 0.79). Scores in the questionnaire were independent of patient’s age, education level, working status and INR value. The most valued features of SintromacWeb® were: fewer visits to the hospital, simplicity and convenience of the system, and time administration for control tasks (86.7%, 82.7% and 77.6% of very satisfied patients, respectively). Also, patients showed indifference or were dissatisfied with the conventional system. At the final visit, 99% of patients declared that they were satisfied with their OAT control. Moreover, all patients continued using Sintrom -acWeb→ after completion of the study. In conclusion, SintromacWeb→ telecontrol is a new model for management of anticoagulated patients. It was highly accepted and can be used by all patients regardless of their sociodemographic characteristics.

Computer-aided dosage in oral anticoagulation therapy using phenprocoumon

2010 ◽  
Vol 30 (04) ◽  
pp. 183-189 ◽  
Author(s):  
H. Völler ◽  
F. Gäbler ◽  
A. Salzwedel ◽  
U. Taborski ◽  
L. Cromme
Keyword(s):  
Oral Anticoagulation ◽  
Vitamin K Antagonists ◽  
Anticoagulation Therapy ◽  
Target Range ◽  
Patient Specific ◽  
Oral Anticoagulation Therapy ◽  
Delayed Effects ◽  
Measurement Results ◽  
Computer Aided ◽  
And Control

SummaryOral anticoagulation using vitamin K antagonists has been established for over 50 years. Although it is highly effective in preventing thromboembolic incidents, its therapeutic control still remains problematic. Therefore, a computer-aided approach is recommended for deriving dosages. Up to now, the dosage is often based on the visual inspection of previous INR measurements, average weekly doses, and the INR target range. Statistical variations of measurement results and time-delayed effects of dosages, however, frequently result in the misinterpretation of data and suggest pseudo-trends. Treating physicians are not only responsible for determining the patient-specific maintenance dose, but must also respond to deviating INR values, overdosage or underdosage, initiate the oral anticoagulation therapy, and control the INR level in case of a new target range (bridging). Instructive examples are provided to illustrate the described difficulties.A computer-aided expert system is currently developed to ensure the therapeutic safety under the specified conditions. We present preliminary results from a study designed to validate mathematical models underlying such expert systems.

scholarly journals The Impact of Using Mobile Applications on Health Outcomes in Patient Self-Management of Oral Anticoagulation Therapy

2021 ◽  
Author(s):  
Hamid Moghaddasi ◽  
Mohammadreza Naderi Haji ◽  
Babak Sharif-Kashani ◽  
Alireza Kazemi
Keyword(s):  
Health Outcomes ◽  
Therapeutic Range ◽  
Oral Anticoagulation ◽  
Mobile Applications ◽  
Mobile Application ◽  
Anticoagulation Therapy ◽  
Self Management ◽  
Oral Anticoagulation Therapy ◽  
The Mean ◽  
The Impact

Abstract Background Between one and two percent of the population of the developed countries are currently treated with oral anticoagulation therapy. The transition of all or part of the responsibility for therapy management to the patient is an appropriate strategy to respond increasing demand for oral anticoagulation therapy. The main objective of this original study was to investigate the impact of using mobile applications on health outcomes in patient self-management of oral anticoagulation therapy. Methods The papers reviewed in this study had two key characteristics: firstly, they were written in English, and secondly, they used mobile application in oral anticoagulation therapy. An Android mobile application called XrinA was developed to provide warfarin patient self-management. The study was conducted following a Before-After study design. In the Before and After periods, patients were treated as usual and by using the developed application, respectively. Results In the Before period, the mean percentage of International Normalized Ratios (INRs) within the therapeutic range and Time in Therapeutic Range (TTR) of patients was 31.63% and 34.4%, respectively. In the After period, the mean percentage of INRs within the therapeutic range and TTR of patients was 41.41% and 49.97%, respectively. In the After period, the mean INRs within the therapeutic range and the mean TTR increased by 9.78% and 15.57%, respectively. Conclusions Overall, the use of mHealth applications improved outcomes in patient self-management of oral anticoagulation therapy in terms of the percentage of INRs within the therapeutic range and TTR.

Technology-assisted self-testing and management of oral anticoagulation therapy: a qualitative patient-focused study

2016 ◽  
Vol 31 (3) ◽  
pp. 603-617 ◽  
Author(s):  
Jasna Kuljis ◽  
Arthur G. Money ◽  
Mark Perry ◽  
Julie Barnett ◽  
Terry Young
Keyword(s):  
Oral Anticoagulation ◽  
Anticoagulation Therapy ◽  
Oral Anticoagulation Therapy ◽  
Self Testing
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