Impact of an oral anticoagulation self-monitoring and self-management program in patients with mechanical heart valve prosthesis

J Comp Eff Res. 2021 Mar;10(4):307-314. doi: 10.2217/cer-2020-0215. Epub 2021 Feb 17.

Abstract

Objective: To analyze impact of implementation of an oral anticoagulation self-monitoring and self-management program among patients with mechanical valve prosthesis. Materials & methods: Observational and retrospective study performed in Hospital Moises Broggi, Barcelona, Spain. The program started on June 2019. The study compared 6-month period before and after the implementation of the program. Results: The study included 44 patients. There was a numerical increase of time in therapeutic range from 53.6 ± 21.3% to 57.1 ± 15.7% (p = 0.30). Proportion of patients with international normalized ratio (INR) >5 significantly decreased from 3.9 to 2.0% (p = 0.04). No significant differences were observed in thromboembolic or bleeding complications. Visits to emergency department decreased from (29.5 to 22.7%; p = 0.41). Conclusion: Oral anticoagulation self-monitoring and self-management program seems an appropriate approach that could provide additional benefits in selected patients with mechanical valve prosthesis.

Keywords: anticoagulation; bleeding; mechanical prosthesis; self-management; self-monitoring; thrombosis; vitamin K antagonists.

MeSH terms

  • Administration, Oral
  • Anticoagulants / therapeutic use
  • Heart Valve Prosthesis Implantation*
  • Heart Valve Prosthesis*
  • Hemorrhage
  • Humans
  • Retrospective Studies
  • Self-Management*
  • Spain

Substances

  • Anticoagulants