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Self-monitoring of blood thinners halves your risk of clots

Carl Heneghan
Last edited 1st December 2011

Here are some links to news stories of cebmblog and colleagues work published in the Lancet today

Self-monitoring of oral anticoagulation: systematic review and meta-analysis of individual patient data Lancet

Self-Monitoring of Blood Thinner May Halve Clot Risk
MSN Health
People taking the blood-thinning drug warfarin who monitor their own blood and adjust their dosage can reduce the risk of blood clots by half, British researchers report. Warfarin is taken to prevent potentially deadly clots in patients with conditions such as atrial fibrillation – an abnormal heart rhythm – or a mechanical heart valve. But if the blood is thinned too much, serious bleeding can occur. Keeping the drug in check requires monthly monitoring and frequent doctors visits. ‘The concept of self-care and self-monitoring is a growing part of health care. It is used widely in diabetes, asthma and hypertension management,’ said lead researcher

Dr Carl Heneghan, director of the Centre for Evidence-Based Medicine at the University of Oxford. ‘The evidence shows that self-monitoring is an effective strategy to reduce thromboembolic events in patients taking oral anticoagulants such as warfarin,’ he added.

Home monitoring of ‘blood thinners’ is effective
Web MD

Patients Can Safely Manage Blood Thinners Themselves
MedPage Today

There is also a neat peice by Jonathan Wood from the University of Oxford press office Blood clot risk halved for patients checking own warfarin dose

Patients who monitor their own treatment with warfarin or other blood-thinning drugs reduce their risk of developing blood clots by half, an Oxford University study has found.......

NNT comparisons

Thanks Greg

yes the NNT are in there to help readers think through comparisons - whether is it better to prevent a thrmoboembolic event or an MI depends very much on the amount of damage- if the event is a stroke then most folk would think that is worse than a MI.

I'd agree with the strategy of targeting those with artificial heart valves given they benefit the most.

Cheers Carl

NNT comparisons and targeting particular patients.

Your comparison of NNTs in the discussion was thought-provoking.

63 people on statins for 5 years prevents one heart attack. 24 people self-monitor for 5 years prevents one thromboembolic event. Is it better for us to prevent an MI or a thromboembolic event? Does this factor into comparing NNTs?

I'm going to find out how many men we have on warfarin for heart valves as this sounds like the population to target first.

Greg.

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