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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
1   Department of Internal Medicine, Medical University of Graz, Austria
,
Ivo Rakovac
2   Institute of Medical Technologies and Health Management, JOANNEUM RESEARCH Forschungsgesellschaft mbH, Graz, Austria
,
Caroline Kleespies
3   DIeM – Institute for Evidence-based Medicine, Cologne, Germany
,
Brigitte Piso
4   Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
,
Ulrike Didjurgeit
3   DIeM – Institute for Evidence-based Medicine, Cologne, Germany
,
for the SPOG 60+ Study Group › Author AffiliationsFinancial support: This study was sponsored by Roche Diagnostics GmbH (Mannheim, Germany).
Further Information

Publication History

Received: 09 June 2008

Accepted after major revision: 17 September 2008

Publication Date:
23 November 2017 (online)

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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
 

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