Thursday, 17. of April 2014
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Anticoagulation management modalities and quality of life

In his second talk of the day, Scott Kaatz elaborated on the multiple modalities available to manage patients who are anticoagulated with Vitamin K antagonists, such as patient education, patient self-testing and patient self-management. Kaatz examined how these different systems affect the patient’s quality of life.
“There has been much scientific emphasis on clinical outcomes of thrombo-embolic and hemorrhagic complications. In contrast the direct impact on patients’ quality of life has been less well investigated,” said Kaatz.
Kaatz had no doubt that the most accurate way to measure the effect of different management modalities on patients’ quality of life is through randomized clinical trials. However, clear answers are prevented by the low availability of studies, especially for the comparison between usual care and anticoagulation management service, as well as multiple evaluation tools and global quality-of-life questionnaires, which may not be precise enough. However, given these limitations, one questionnaire, specifically designed to evaluate the effects of patient self-testing or management on quality of life has been used in several trials and has shown consistent improvement in patients’ well being.
“As compared to usual anticoagulation monitoring, patients enrolled in anticoagulation management service have a perception of improvement in their care. Patients empowered to perform patient self testing or management have further gains in their quality of life,” concluded Kaatz.

Report by Thomas Klein, MD, MSc (Nov. 2009)