Self-managed anticoagulation: results from a two-year prospective randomized trial with heart valve patients

Ann Thorac Surg. 2001 Nov;72(5):1523-7. doi: 10.1016/s0003-4975(01)03049-1.


Background: This study was conducted to assess the ability of patients receiving heart valve replacements to practice self-managed anticoagulation using a portable coagulometer.

Methods: We carried out a prospective, randomized trial, comparing self-managed anticoagulation with conventional management. Patients practicing self-managed anticoagulation (51 patients) did so at home, measuring their international normalized ratio and then deciding on their dosage of warfarin, while conventionally controlled patients (n = 49) attended hospital clinics or were managed by their family physicians.

Results: We successfully trained 41 of 44 patients who agreed to self-manage their anticoagulant therapy; 34 of the 41 managed their own anticoagulation at home for 2 years. Their control, assessed by a number of tests in range (67.6% versus 58.0%) and time in therapeutic range (76.5% versus 63.8%), was significantly better than that for the group managed conventionally (p < 0.0001). There was no significant difference in mortality or morbidity between the two groups.

Conclusions: Self-managed anticoagulation is a reliable, easily learned method of controlling anticoagulation, and it is suitable for approximately two thirds of patients, with excellent results.

Publication types

  • Clinical Trial
  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / therapeutic use*
  • Female
  • Follow-Up Studies
  • Heart Valve Prosthesis*
  • Humans
  • Male
  • Middle Aged
  • Monitoring, Ambulatory*
  • Prospective Studies
  • Self Administration
  • Warfarin / therapeutic use*


  • Anticoagulants
  • Warfarin