Self-monitoring benefits patients on blood-thinners

By Patricia Reaney

LONDON (Reuters) – Self-monitoring by patients taking
anti-clotting drugs is safe, effective and could lead to fewer
deaths, researchers said on Friday.

Anticoagulants, or blood thinners, are a common treatment
to prevent blood clots and strokes. Millions of people take the
drugs but their reaction to the treatment must be tested
regularly to prevent bleeding or hemorrhage.

Carl Heneghan, of Oxford University in England, found that
patients who monitored their own treatment with a home testing
kit and adjusted their dose suffered fewer blood clots and
deaths than people tested by medical professionals.

“The time has come for people to start self monitoring on
oral anticoagulation and for healthcare providers to take this
seriously,” he said in an interview.

Heneghan and a team of scientists in England and Spain
analyzed the results of 14 studies from Europe, Canada and the
United States involving 3,000 patients taking the drug thinner
warfarin.

The pooled results, which are published in The Lancet
medical journal, showed patients who self-monitored their
treatment had less blood clots and hemorrhages and about
one-third fewer deaths from all causes.

“If you select the right patients, what you see is not only
that is it safe, it is also effective in reducing the number of
blood clots, and a reduction in overall deaths,” Heneghan said.

“People who are able to self-adjust therapy do even
better.”

Not all patients can monitor their treatment. Some people
are reluctant or have physical limitations that prevent them.

Monitoring is important because blood-thinners can interact
with antibiotics and alcohol and are affected by certain types
of food.

Self monitoring involves taking a blood sample from a pin
prick and putting it into a home testing kit. The machine gives
a reading that shows if the patient is in a safe range and not
at risk of bleeding or having a blood clot, or if the dose
needs to be adjusted.

Monitoring is done almost daily in the early days of
treatment and reduced over time to about once a month.

“These trials have been going on since 1989. No single
trial has shown significantly there is a reduction in death or
thromboembolism (blood clots) but by pooling them all together
for the first time that is what we are seeing,” Heneghan added.