Azarnoush K(2014)
|
France
|
Quasi-experiment
|
178
|
4.2 ± 1 years
|
mechanical
|
There were significantly fewer bleeding complications and complications related to VKA in self-measured patients and Feelings of security and quality of life were also better.
|
Self-monitoring device should be provided and self-monitoring INR method as well as training of vitamin K antagonists should be trained. Also Financial support should be provided .
|
Christensen TD(2003)
|
Denmark
|
Quasi-experiment study
|
197
|
2.1 year
|
mechanical
|
SM of oral anticoagulant therapy provides a good treatment quality for mechanical heart valve patients. herefore self-management of oral anticoagulant therapy as an equally as good or potentially better treatment option compared to conventional management.
|
Training SM to patients, training of Blood sampling and analysis, Start SM gradually and under supervision, Start SM after taking the ability test, Patient Relationship with Medical Centers and Report of Test Results, Drugs, Complications and Asking questions. Family support
|
Christensen TD(2001)
|
Denmark
|
Quasi-experiment study.
|
48
|
4 years
|
mechanical
|
SM of OAT is a feasible and safe concept also on a long-term basis. It provides at least as good and most likely better quality of anticoagulant therapy than conventional management assessed by time within the therapeutic International Normalized Ratio (INR) target range.
|
For self-monitoring, the patient to be trained to use the CoaguChekb coagulometer and PT-test strip and finger puncture. Practicing blood specimen and analysis. Start SM gradually and under supervision. Must be assured of patient's SM capacity.
|
Christensen, T. D. (2016)
|
Denmark
|
Matched Cohort Study
|
615 + 3,075
|
5 year
|
mechanical
|
PSM was associated with a lower risk of all-cause mortality. Self-managed oral anticoagulant therapy may potentially improve the standard of care.
|
All patients need to an educational program containingincluding basic theoretical and practical skills that involved use of the coagulometer, interpretation of international normalized ratio values, and VKA dosing.
|
Fritzsche, D
(2007)
|
Germany
|
RCT
|
541
|
25.2 months
|
mechanical
|
Analysis of sound frequency spectra by the ThromboCheck identified prosthetic heart valve dysfunction before clinical symptoms developed, and promoted early therapy. By using the ThromboCheck device the patients felt safer with regards to prosthetic valve dysfunction.
|
Patients should be received instructions on the use of the ThromboCheck early after surgery. The device was calibrated by recording the baseline valve sound characteristics of each patient. Use of this device should be monitored.
|
Thompson,
(2008)
|
USA
|
RCT
|
50
|
1 month
|
mechanical
|
This patients are able to learn INR self-testing and that most will continue to use the method without the need for interval instruction.
|
Instructions for using a coagulometer, Review the importance of using anticoagulation, correct way to obtain a sample of blood using a fingerstick, and included the importance of hand hygiene.
|
Jeon, H. R
(2015)
|
Korea
|
RCT
|
33
|
|
|
SM program based on PT INR monitoring showed that it is effective in improving self-management knowledge, self-efficacy, and SM behavior as well as maintaining treatment range of PT INR of patients with cardiac valve replacement.
|
Individual training on opiates, diet, daily living, exercise, stress management, pt&inr self-examination methods, precautions for anticoagulant use, drug interactions, side effects of medications, surgical wound management, telephone counseling
|
Koertke, H
(2015)
|
Germany
|
RCT
|
1800
|
18 months
|
mechanical
|
Telemedicine-guided very low-doseINR self-control is comparable with low-doseINR in thrombotic risk, and is superior in bleeding risk. Weekly testing is sufficient.
|
several factors such as the vitamin K content of the diet, concomitant medications, alcohol consumption, climate, stress, and physical activity,Procedures that be performed if the measured INR value lies outside the target range and how to adjust the daily dose of anticoagulants to optimize the INR value Must be trained.
|
Sidhu, P
(2001)
|
Northern Ireland
|
RCT
|
100
|
4 months
|
mechanical
|
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.
|
Providing information on blood coagulation, diagnosis of anticoagulation and infection complications, how drugs, diet, alcohol consumption, Training on the use of the CoaguChek device and the importance of hand hygiene. Evaluation of patients' SM ability.
|
Thompson, J.
(2013)
|
USA
|
RCT
|
200
|
3 months
|
mechanical
|
Management of anticoagulation is improved with self-testing, even during the early postoperative phase when international normalized ratio testing is performed frequently.
|
The educational program must be include an overview of INR selftesting and the coagulometer and the proper methods for sampling using a finger stick, the use of the coagulometer, and recording the test results.
|
Fritzsche, D
(2007)
|
Germany
|
Quasi-experiment
|
483
|
15.1 months
|
mechanical
|
Digital frequency analysis represents a reasonable addition to the monitoring of patients to detect prosthesisrelated complications early on.
|
Frequency of prosthetic dysfunction can be detected by ThromboCheck. The early detection of dysfunction should enable suitable treatment strategies to be deduced. In all patients must be evaluated an altered frequency range as early detection of a mechanical valve dysfunction and recommended medical clarification.
|
Hasenkam (1998)
|
Denmak
|
Quasi-experiment
|
41
|
9months
|
mechanical
|
SM of oral anticoagulation is feasible for this patients. The CoaguChek
Monitor seems sufficiently accurate and reliable for self-testing.
|
Training of self-analysis, Instructions for using the using the CoaguChek Monitor and blood specimen analysis based on capillary blood samples.
|
Körtke, H (2001)
|
Germay
|
IRC
|
1158
|
2 year
|
mechanical
|
The results differed slightly in quality between patient groups with different levels of training. Overall, 91.7% of these patients are self-managed. Quality of oral anticoagulation also improved.
|
Training SM to patients. Instructions for using a coagulometer.
|
Fritzsche, D (2004)
|
Germay
|
Quasi-experiment
|
30
|
6months
|
mechanical
|
This study present a reliable method for early detection of prosthetic valve dysfunction which can be applied daily with minimal effort by the patient himself.
|
Online recording of acoustic phenomena by Home monitoring of patients is useful for detecting even minimal changes in prosthesis function.
|
Soliman Hamad (2009)
|
Netherlands
|
RCT
|
62
|
1 year
|
mechanical
|
SM program after adequate training improves the INR control. Postoperative improvement in the quality of life was significant in the physical component summary only.
|
Patients should receive special information. CoaguChek and all disposable items should be provided to patients. Patient must receive sufficient training. patient had to pass an exam of SM
|
Eitz, T
(2008)
|
Germany
|
RCT
|
765
|
2 years
|
mechanical
|
Anticoagulation SM can improve INR profiles up to 2 years after prosthetic valve replacement and reduce adverse events
|
instructions on use of the CoaguChek device, adjustments of warfarin dosages cannot be predefined because of varying needs for vitamin K antagonism. dosage adjustments must consider previous dosages and INR profiles. Ensure patient SM skills
|
Koertke, H.
(2005)
|
Germany
|
RCT
|
1818
|
2 years
|
mechanical
|
Low-dose INR SM is a promising tool to achieve low hemorrhagic complications without increasing the risk of thromboembolic complications. INR SM is applicable for all patients in whom permanent anticoagulation therapy is indicated
|
The low-dose had a target range of 1.8 to 2.8 for aortic valve recipients and 2.5 to 3.5 for mitral or double valve recipients. patients who depend on long-term anticoagulation therapy are able to selfresponsibly determine the INR values and correct the dose of anticoagulants. INR measurements were performed with a coagulation monitor
|
Koertke, H (2007)
|
Germay
|
RCT
|
930
|
12 years
|
mechanical
|
SM of oral anticoagulation is a promising strategy in order to increase long-term survival in patients with mechanical prosthetic valves.
|
Self-management must be trained
|
Kortke, H (2001)
|
Germany
|
RCT
|
600
|
2-year
|
mechanical
|
SM can cause improvement in the quality of ongoing oral anticoagulation. Starting this form of therapeutic control early after mechanical heart valve replacement appears to effect a further reduction in anticoagulant-induced complications.
|
Patients with SM should receive training 6 to 11 days after surgery days after operation then received a coagulation monitor
|
Koertke, H (2003)
|
Germany
|
RCT
|
1818
|
2 years
|
mechanical
|
Early onset INR SM under oral anticoagulation enables patients to keep within a lower and smaller INR target range. That resulted in fewer bleeding complications without increasing thromboembolic event rates.
|
SM Training began 6 to 11 days after surgery. Every patient who passed the INR self-management examination received a coagulation monitor. Every month the study center received the INR values recorded by the patients themselves. Patients were asked to report any complication (thromboembolism, bleeding) immediately.
|
Mair, H (2012)
|
Germay
|
retrospective
|
420
|
8.6 ± 2.1 years
|
mechanical
|
Self-M of OA improves long-term outcome and treatment quality.
|
Patients trained according to the guidelines of the Anticoagulation Specialist Association. The main goals were to achieve accurate INR results by self-testing (finger-pricking) and correct interpretation of the INR data with appropriate change of the anticoagulant dosage.
|
Chen, Q. L (2015)
|
China
|
RCT
|
526
|
6 months
|
mechanical
|
esults of CoaguChek XS monitor are precise and have a good consistency and stability. the self-testing of anticoagulation therapy with portable coagulometer is a safe choice.
|
self-testing methods are used in parallel to check and record the INR values of the patients about 0.01 cm3 blood at the end of capillary of finger is collected by the patients themselves or their actual caregivers, and tested with CoaguChek XS portable coagulometer.
|
Koertke, H. (2001)
|
Germany
|
RCT
|
600
|
2 years
|
mechanical
|
INR SM reduced severe hemorrhagic and thromboembolic complications we conclude that all patients for whom anticoagulation is indicated are candidates for INR SM regardless of education level.
|
SM Training began 6 to 11 days after surgery. Every patient who passed the INR self-management examination received a coagulation monitor
|
Koertke, H.
(2005)
|
Germany
|
RCT
|
1818
|
2 years
|
mechanical
|
low-dose INR SM does not increase the risk of thrombo-embolic events compared with conventional dose INR self-management. Even in patients with low INR target range, the risk of bleeding events is still higher than the risk of thrombo-embolism.
|
The low-dose had a target range of 1.8 to 2.8 for aortic valve recipients and 2.5 to 3.5 for mitral or double valve recipients. patients who depend on long-term anticoagulation therapy are able to selfresponsibly determine the INR values and correct the dose of anticoagulants. INR measurements were performed with a coagulation monitor
|
Koertke, H(2010)
|
Germany
|
RCT
|
1137
|
6 months
|
mechanical
|
Very Low-Dose Self-Management of Oral Anticoagulation doesn't have a significantly different from conventional methods in terms of clinical outcomes, such as the incidence of thromboembolic events requiring hospitalization, bleeding events nd mortality.
|
Very Low-Dose Self-Management of Oral Anticoagulation is effective and safe for patients.
|