The main topic of this conference was the education of anticoagulated patients. What can ISMAAP and their national members do to provide education to help prevent bleeding and thromboembolism? The consensus of the delegates was: There is a lack of compliance in patients taking anticoagulants and this can lead to a higher rate of bleeding and thromboembolism. Better-educated and trained patients are able to have a better partnership with the physician and better-trained patients will have reduced risks of bleeding and thromboembolism.PD Dr. med. Heinrich Koertke, Heart-Centre North-Rhine-Westphalia, Germany, pointed out that several studies (ESCAT I, II, III and the Teleqin-study) have shown that the INR self-management gives the anticoagulated patients a greater degree of safety. The first results of the recent Teleqin-study show that 83,3 % of the INR-values were within the therapeutic range. In this study patients transferred their INR-results via a modem to the Heart-Centre. Physicians control the date for the next test and give a feedback to the patients. If the INR-values are outside of the therapeutic range the physician discusses the matter with the patient and if it is necessary advises on dose changes.PD Dr. Koertke concluded that anticoagulated patients practising INR self-management are able to control their monitoring and dosing, and that only 5 % of them need additional support via telemedicine.Dr. med. Andrea Siebenhofer, Graz/Austria, presented the first results of the SPOG60+-study. The study concluded that patients over 60 years of age have no problems learning to self-mange their INR. If elderly patients are handicapped then their partner, other relatives or friends can be trained to manage the INR self-testing for them.There was also discussion on how to train children to self-manage. Agnes Pelladeau, France, reported on her own experience with anticoagulated children. First the parents have to be trained and then they can teach the child. But at present there is a lack of suitable training programmes.The 30 delegates of this conference heard an interesting talk by Christian Schaefer, Germany, in which he described how ISMAAP had been founded and its activities up to now. The close cooperation with the national members has led to a well-known and active organization. He gave examples of ISMAAP activities including Patient/Physician-Symposia, activities at medical congresses, publications in medical magazines, national patient days (e.g. the National Anticoagulation Day) and the annual ISMAAP conference on anticoagulant therapy.
C. Schaefer (Nov. 2007)
From l. to r. Christian Schaefer (Germany), Jacques Glineur (Belgium), Cees N de Graaff (The Netherlands), PD Dr. med. Heinrich Koertke (Germany), Nini Leroul (Denmark), Nicola Merlin(Italy), Dra. Adela Zaragozá Catálán (Spain), Preben Mandrup (Denamark), Agnes Pelladeau (France), Ulrike Walchshofer (Austria), Albert O. Meyer (Switzerland)