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Oral anticoagulation and self-management: analysis of the factors that determine the feasibility of using self-testing and self-management in primary care

Eduardo Tamayo Aguirre1*, Itziar Vergara-Mitxeltorena23, Edurne Uranga Saez del Burgo4, Aitziber Ostiza-Irigoyen5, Alejandro Garcia-Carro6, Isabel Lopez-Fernandez7 and Arrate Galo-Anza1

Author Affiliations

1 Gros Health Centre, Donostia, Gipuzkoa, Spain

2 Primary Care Research Unit-Gipuzkoa, Osakidetza, Spain

3 Red de investigación en servicios de salud en enfermedades crónicas (REDISSEC), Centro de investigación en cronicidad Kronikgune, Osakidetza, Spain

4 Pasai Donibane Health Centre, Gipuzkoa, Spain

5 Usurbil Health Centre, Gipuzkoa, Spain

6 Egia Health Centre, Donostia, Spain

7 Lasarte Health Centre, Gipuzkoa, Spain

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BMC Cardiovascular Disorders 2013, 13:59  doi:10.1186/1471-2261-13-59

Published: 22 August 2013



The skills of patients on oral anticoagulants are critical for achieving good outcomes with this treatment. Self-management, or the capacity of patients to control their INR level and adjust their treatment, is an effective strategy of treatment. Capacity of patients to self manage is determined by a range of factors. The identification of these factors would improve the design of self management programmes and in turn increase the number of patients able to self-manage. The objective of our study is to identify those factors that determine the ability of patients on oral anticoagulant therapy to achieve self-management of their treatment.


This will be a three year quasi- experimental prospective study with a control group. 333 patients on anticoagulant therapy from five health centres of the Basque Health Service are to be followed up for a period of six months each after the intervention, to assess their ability to self-test and self-manage. The intervention will consist of a patient training programme involving the provision of information and practical training concerning their condition and its treatment, as well as how to use a portable blood coagulation monitoring device and adjust their anticoagulant dose.


The ease-of-use of this technique lead us to believe that self-management is feasible and will represent an innovative advance that should have a substantial impact on the quality of life of this patients and their families as well as on the health care provision systems.

Trial registration

Osakidetza Protocol Record ISCIII-11/02285, Oral anticoagulation and self-management, Identifier: NCT01878539

Oral anticoagulants; Self-management; Determinants