Patient self-control of oral anticoagulation with CoaguChek (R)

We investigated the feasibility, quality and safety of patient self-control of oral anticoagulation. The patients were selected by their physicians on the basis of criteria such as compliance, skills and motivation. After the oretical and practical training they self-monitored and self-adjusted their anticoagulant dosage for 6 months by weekly self-measurement of their INR values using a capillary whole blood prothrombin time monitor (CoaguChek(R) ). Venous INR measurements once a month served as quality control. There we re 51 study participants, who performed a median 5 INR measurements per mon th. 75.8% of all registered INR values were within the recommended individu al INR target ranges. The coefficient of correlation between capillary (y) and venous (x) INR values was r = 0.87 (regression analysis y = 1.0 x -0.2) . The concordance of capillary and venous INR values was 80% with respect t o the individual INR target ranges. There were 5 minor bleeding episodes an d no overt thromboembolic recurrences during the study period. In conclusio n, the study demonstrated that patient self-control of oral anticoagulation is feasible and achieves a high percentage of INR values within the recomm ended target ranges. Therefore, self-control of oral anticoagulation can be offered to skilled and motivated patients as an alternative to physician-g uided anticoagulation. However, specific training of these selected patient s is necessary.