Is self-monitoring an effective option for people receiving long-term vitamin K antagonist therapy? A systematic review and economic evaluation

Review of 26 RCTs (n=8763) suggests self-monitoring (SM) appears to be a safe and cost-effective option. It found that both SM and self-testing were as safe as standard care (SC) in terms of major bleeding events. SM was linked to fewer thromboembolic events compared with SC.

NICE diagnostic guidance supports the use of the CoaguChek XS system or the InRatio2 PT/INR monitor for self monitoring coagulation status in adults and children on long term vitamin K antagonist therapy who have atrial fibrillation or heart valve disease if: the person prefers this form of testing and the person or their carer is both physically and cognitively able to self monitor effectively.

 

The guidance notes that although there is greater uncertainty of clinical benefit for the InRatio2 PT/INR monitor than for the CoaguChek XS system, the evidence indicates that the precision and accuracy of both monitors are comparable to laboratory based INR testing.