Self-management of oral anticoagulation reduces major outcomes in the elderly

Andrea Siebenhofer; Ivo Rakovac; Caroline Kleespies; Brigitte Piso; Ulrike Didjurgeit; for the SPOG 60+ Study Group

doi:10.1160/TH08-06-0361

Thrombosis and Haemostasis, Table of Contents

Thromb Haemost 2008; 100(06): 1089-1098
DOI: 10.1160/TH08-06-0361

Blood Coagulation, Fibrinolysis and Cellular Haemostasis

Schattauer GmbH

Self-management of oral anticoagulation reduces major outcomes in the elderly

A randomized controlled trial

Andrea Siebenhofer

¹Department of Internal Medicine, Medical University of Graz, Austria

,

Ivo Rakovac

²Institute of Medical Technologies and Health Management, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria

,

Caroline Kleespies

³DIeM – Institute for Evidence-based Medicine, Cologne, Germany

,

Brigitte Piso

⁴Department of Internal Medicine, Medical University of Vienna, Vienna, Austria

,

Ulrike Didjurgeit

³DIeM – Institute for Evidence-based Medicine, Cologne, Germany

,

for the SPOG 60+ Study Group

› Author Affiliations

Abstract

Summary

Although many patients with long-term oral anticoagulation (OAC) can manage their medication safely and reliably themselves, no study on elderly patients has as yet assessed the safety and efficacy of OAC self-management with major thromboembolic and haemorrhagic complications as primary outcomes. In this multi-centre trial, patients aged 60 years or more were randomised into a self-management (SMG) (N=99) or routine care group (RCG) (N=96).The primary outcome was the combined endpoint of all thromboembolic events requiring hospitalisation and all major bleeding complications. Mean follow-up was 2.9 ± 1.2 and 3.0 ± 1.1 years in the SMG and RCG, respectively. In intention-to-treat analysis, 12 patients in the SMG versus 22 patients in the RCG reached a primary endpoint (hazard ratio [HR]: 0.50; 95% confidence interval [CI]: 0.25 to 1.00; p=0.049).

Keywords

Oral anticoagulation - self-management - elderly patients - randomized controlled trial

Full Text

References

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