Self-monitoring aids patients on blood-thinners

Updated: 7:58 p.m. ET Feb. 2, 2006

LONDON - 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.

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