State-of-the-art patient self-management for control of oral anticoagulation

Currently, in Germany, there is a successful program where patients monitor their own coagulation status through self-testing. The advent of a new gen eration of coagulometers has allowed more and more patients to use self-tes ting to monitor their coagulation status, The development of a structured t raining program by the Association of Self-Management of Anticoagulation (A SA), and the effective cost reimbursement system by health insurance compan ies has furthered the success of this program. The reliability of the coagu lometers is quite important to the success of this program, and has been ex tensively evaluated, These systems are characterized by high accuracy and p recision, and low intra-/interassay variation. They also exhibit excellent recovery of the therapeutic range. Several clinical studies have shown that patients performing self-management remain in the therapeutic range a grea ter percentage of the time when compared to conventional testing, and tende d to have less incidences of bleeding or thromboembolic complications. It i s estimated that about 50 to 60% of all patients on anticoagulant therapy i n Germany are suitable candidates for self-management.