Titre :
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Oral anticoagulation self-management and management by a specialist anticoagulation clinic : a randomised cross-over comparison. (2000)
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Auteurs :
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M.E. CROMHEECKE ;
H.R. BULLER ;
L.P. COLLY ;
B.J.M. DE MOL ;
B.A. HUTTEN ;
K.C.J. KEYZERS ;
M. LEVI ;
R. MAK ;
M.H. PRINS ;
Department of Cardiopulmonary Surgery. Academic Medical Centre. University of Amsterdam. Amsterdam. NLD ;
Department of Vascular Medicine and Department of Internal Medicine. Academic Medical Centre. University of Amsterdam. Amsterdam. NLD
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Type de document :
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Article
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Dans :
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Lancet (The) (vol. 356, n° 9224, 2000)
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Pagination :
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97-102
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Langues:
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Anglais
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Mots-clés :
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Médicament anticoagulant
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Etude comparée
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Hôpital
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Gestion
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Résultat
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Homme
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Hématologie
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Résumé :
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[BDSP. Notice produite par INIST gaR0xcYQ. Diffusion soumise à autorisation]. Background Vitamin K antagonist treatment is effective for prevention and treatment of thromboembolic events but frequent laboratory control and dose-adjustment are essential. Small portable devices have enabled patient self-monitoring of anticoagulation and self-adjustment of the dose. We compared this self-management of oral anticoagulant therapy with conventional management by a specialist anticoagulation clinic in a randomised crossover study. Methods 50 patients on long-term oral anticoagulant treatment were included in a randomised controlled crossover study. Patients were self-managed or were managed by the anticoagulation clinic for a period of 3 months. After this period the altemative strategy was followed for each patient. Prothrombin time (expressed as international normalised ratio [INR]) were measured at intervals of 1-2 weeks in both periods without knowledge of type of management. The primary endpoint was the number of measurements within the therapeutic range (therapeutic target value 50.5 INR units). Findings There was no significant difference in the overall quality of control of anticoagulation between the two study periods. Patients were for 55% and for 49% of the treatment period within a range of 0.5 from the therapeutic target INR during self-management and anticoagulation clinic management, respectively (p=0.06). (...)
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