BACKGROUND AND OBJECTIVE: We aimed to systematically review the scientific evidence about the use of portable coagulometers for patient's self-management of oral anticoagulant treatment. MATERIAL AND METHOD: Systematic review of scientific evidence available from MEDLINE'S, DARE's, HTA-Database's, NHS-EED's and The Cochrane Library' s bibliographic databases, from their origin to March 2003. Randomized control trials (RCT) and Quasi-Experimental trials were selected provided that they compared patients in self-management with patients under usual care. The quality of scientific evidence was elicited using the Scottish Intercollegiate Guideline Network (SIGN) recommendations, whilst efficacy and security were descriptively summarized. RESULTS: Twelve (7 RCT and 5 quasi-experimental trials) articles were found, and only two of them provided grade A recommendation. Patients under self-management remained the same or more time in the therapeutic range. The incidence of adverse effects in self-management patients was the same or less than that in patients under usual care. CONCLUSIONS: The quality of the scientific evidence is heterogeneous. For selected patients, patient's self-management is at least as effective and safe as usual care. New oral anticaogulants, which have shown promising results, should be scrutinized for future changes in service provision.
BACKGROUND AND OBJECTIVE: We aimed to systematically review the scientific evidence about the use of portable coagulometers for patient's self-management of oral anticoagulant treatment. MATERIAL AND METHOD: Systematic review of scientific evidence available from MEDLINE'S, DARE's, HTA-Database's, NHS-EED's and The Cochrane Library' s bibliographic databases, from their origin to March 2003. Randomized control trials (RCT) and Quasi-Experimental trials were selected provided that they compared patients in self-management with patients under usual care. The quality of scientific evidence was elicited using the Scottish Intercollegiate Guideline Network (SIGN) recommendations, whilst efficacy and security were descriptively summarized. RESULTS: Twelve (7 RCT and 5 quasi-experimental trials) articles were found, and only two of them provided grade A recommendation. Patients under self-management remained the same or more time in the therapeutic range. The incidence of adverse effects in self-management patients was the same or less than that in patients under usual care. CONCLUSIONS: The quality of the scientific evidence is heterogeneous. For selected patients, patient's self-management is at least as effective and safe as usual care. New oral anticaogulants, which have shown promising results, should be scrutinized for future changes in service provision.
Authors: Javier Caballero-Villarraso; Román Villegas-Portero; Fernando Rodríguez-Cantalejo Journal: Aten Primaria Date: 2010-10-30 Impact factor: 1.137
Authors: Carl J Heneghan; Josep M Garcia-Alamino; Elizabeth A Spencer; Alison M Ward; Rafael Perera; Clare Bankhead; Pablo Alonso-Coello; David Fitzmaurice; Kamal R Mahtani; Igho J Onakpoya Journal: Cochrane Database Syst Rev Date: 2016-07-05
Authors: Carl Heneghan; Rafael Perera; Alison Ward A; David Fitzmaurice; Emma Meats; Paul Glasziou Journal: BMC Med Res Methodol Date: 2007-05-02 Impact factor: 4.615
Authors: Misericòrdia Carles; Max Brosa; Juan Carlos Souto; Josep Maria Garcia-Alamino; Gordon Guyatt; Pablo Alonso-Coello Journal: BMC Health Serv Res Date: 2015-07-28 Impact factor: 2.655
Authors: E Tamayo Aguirre; A Galo-Anza; O Dorronsoro-Barandiaran; E Uranga-Saez Del Burgo; A Ostiza Irigoyen; A Garcia-Carro; I Lopez-Fernandez; N Colera; P Saez-Garbayo; I Tamayo-Uria Journal: BMC Cardiovasc Disord Date: 2016-09-13 Impact factor: 2.298