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Letters |6 September 2011

Effect of Patient Self-testing and Self-management of Long-Term Anticoagulation on Major Clinical Outcomes

Andrea Siebenhofer, MD; Klaus Jeitler, MD; Ivo Rakovac, PhD

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Author, Article, and Disclosure Information
Potential Conflicts of Interest: None disclosed.
  • From Institute of General Practice, Goethe University Frankfurt, 60590 Frankfurt am Main, Germany; Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036 Graz, Austria; and Institute for Biomedicine and Health Sciences, Joanneum Research, 8010 Graz, Austria.
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Potential Conflicts of Interest: None disclosed.
TO THE EDITOR:
We found the recent article by Bloomfield and colleagues (1) very interesting. Having recently conducted a trial on the same subject (2), we feel that some issues require further clarification.
Because patient self-testing and self-management are very different, variations in the effectiveness of the 2 interventions deserve special attention. Self-testing enables patients only to monitor the international normalized ratio, whereas self-management empowers patients to take action in achieving better anticoagulation control. Figuratively speaking, self-testing, in contrast to self-management, is like being a passenger watching the speedometer instead of being in the driver's seat. It would therefore be very helpful to readers if the results of sensitivity and corresponding subgroup analyses were published, not least because statistically significant interactions between self-testing and self-management were also found.
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Siebenhofer A, Jeitler K, Rakovac I. Effect of Patient Self-testing and Self-management of Long-Term Anticoagulation on Major Clinical Outcomes. Ann Intern Med. ;155:336. doi: 10.7326/0003-4819-155-5-201109060-00018

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Published: Ann Intern Med. 2011;155(5):336.

DOI: 10.7326/0003-4819-155-5-201109060-00018

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