Context

Although oral anticoagulation with vitamin K antagonists reduces major thromboembolism in high-risk patients, it requires frequent laboratory monitoring to prevent over-anticoagulation which can result in serious bleeding or under anticoagulation which increases the risk for thromboembolism. This monitoring typically occurs in clinical settings, but with marketing of accurate and reliable portable devices, it can now be done more conveniently by the patient at home. Several clinical trials have evaluated the safety and efficacy of patient self-monitoring: either patient self-management (patient tests and adjusts the dose as needed) or patient self-testing with clinical dosing (dosing changes determined by clinicians). Heneghan …