ABSTRACT
Despite its widespread use, oral anticoagulation therapy suffers from a number of
problems that lead to underuse and inadequate treatment. Problems include its narrow
therapeutic index, the influence of many concomitant conditions or comorbidities,
and the need for high-quality dose management. Poor management of oral anticoagulation
is a prime factor influencing the occurrence of adverse events. As a result of these
problems, special programs or anticoagulation management services (AMSs) have developed
to manage oral anticoagulation. Such programs have demonstrated a significant improvement
in outcomes compared with traditional or usual care (UC) by individual physicians.
With the introduction of point-of-care prothrombin time monitors, the potential for
patient self-testing and self-management has developed. Studies show the possibility
of even further improvement in outcomes compared with UC, although the differences
from those achieved with an AMS are less impressive.
KEYWORDS
Oral anticoagulation - warfarin - prothrombin time - International Normalized Ratio
- adverse events - point-of-care monitoring