Is self-monitoring an effective option for people receiving long-term vitamin K antagonist therapy? A systematic review and economic evaluation

Pawana Sharma, Graham Scotland, Moira Cruickshank, Emma Tassie, Cynthia Fraser, Christopher David Burton, Bernard Croal, Craig R Ramsay, Miriam Giovanna Brazzelli

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Abstract

Objectives To investigate the clinical and cost-effectiveness of self-monitoring of coagulation status in people receiving long-term vitamin K antagonist therapy compared with standard clinic care.

Design Systematic review of current evidence and economic modelling.

Data sources Major electronic databases were searched up to May 2013. The economic model parameters were derived from the clinical effectiveness review, routine sources of cost data and advice from clinical experts.

Study eligibility criteria Randomised controlled trials (RCTs) comparing self-monitoring versus standard clinical care in people with different clinical conditions. Self-monitoring included both self-management (patients conducted the tests and adjusted their treatment according to an algorithm) and self-testing (patients conducted the tests, but received treatment recommendations from a clinician). Various point-of-care coagulometers were considered.
Original languageEnglish
Article numbere007758
Number of pages15
JournalBMJ Open
Volume5
Issue number6
Early online date25 Jun 2015
DOIs
Publication statusPublished - 25 Jun 2015

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Vitamin K
Cost-Benefit Analysis
Information Storage and Retrieval
Point-of-Care Systems
Economic Models
Self Care
Therapeutics
Randomized Controlled Trials
Economics
Databases
Costs and Cost Analysis

Cite this

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title = "Is self-monitoring an effective option for people receiving long-term vitamin K antagonist therapy? A systematic review and economic evaluation",
abstract = "Objectives To investigate the clinical and cost-effectiveness of self-monitoring of coagulation status in people receiving long-term vitamin K antagonist therapy compared with standard clinic care. Design Systematic review of current evidence and economic modelling. Data sources Major electronic databases were searched up to May 2013. The economic model parameters were derived from the clinical effectiveness review, routine sources of cost data and advice from clinical experts. Study eligibility criteria Randomised controlled trials (RCTs) comparing self-monitoring versus standard clinical care in people with different clinical conditions. Self-monitoring included both self-management (patients conducted the tests and adjusted their treatment according to an algorithm) and self-testing (patients conducted the tests, but received treatment recommendations from a clinician). Various point-of-care coagulometers were considered.",
author = "Pawana Sharma and Graham Scotland and Moira Cruickshank and Emma Tassie and Cynthia Fraser and Burton, {Christopher David} and Bernard Croal and Ramsay, {Craig R} and Brazzelli, {Miriam Giovanna}",
note = "Date of Acceptance: 07/05/15 This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ Acknowledgements The authors would like to thank the investigators who kindly provided additional trials details, the NICE Assessment Subgroup specialist members (Dianna Oxley, Dianne Kitchen, Niall O’Keeffe, Peter Birtles, Peter MacCallum, Rishabh Prasad, and Sue Rhodes) for their assistance with some queries related to the interventions and their use in clinical practice, Charles Boachie for statistical support, and Lara Kemp for secretarial support. Funding This report was commissioned by the NIHR HTA Programme as project number 13/06/2001. The Health Services Research Unit, and Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, are both core-funded by the Chief Scientist Office of the Scottish Government Health Directorates. The views expressed in this report are those of the authors and not necessarily those of the Chief Scientist Office of the Scottish Government Health Directorates, NIHR HTA Programme or the Department of Health. Any errors are the responsibility of the authors.",
year = "2015",
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T1 - Is self-monitoring an effective option for people receiving long-term vitamin K antagonist therapy? A systematic review and economic evaluation

AU - Sharma, Pawana

AU - Scotland, Graham

AU - Cruickshank, Moira

AU - Tassie, Emma

AU - Fraser, Cynthia

AU - Burton, Christopher David

AU - Croal, Bernard

AU - Ramsay, Craig R

AU - Brazzelli, Miriam Giovanna

N1 - Date of Acceptance: 07/05/15 This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/ Acknowledgements The authors would like to thank the investigators who kindly provided additional trials details, the NICE Assessment Subgroup specialist members (Dianna Oxley, Dianne Kitchen, Niall O’Keeffe, Peter Birtles, Peter MacCallum, Rishabh Prasad, and Sue Rhodes) for their assistance with some queries related to the interventions and their use in clinical practice, Charles Boachie for statistical support, and Lara Kemp for secretarial support. Funding This report was commissioned by the NIHR HTA Programme as project number 13/06/2001. The Health Services Research Unit, and Health Economics Research Unit, Institute of Applied Health Sciences, University of Aberdeen, are both core-funded by the Chief Scientist Office of the Scottish Government Health Directorates. The views expressed in this report are those of the authors and not necessarily those of the Chief Scientist Office of the Scottish Government Health Directorates, NIHR HTA Programme or the Department of Health. Any errors are the responsibility of the authors.

PY - 2015/6/25

Y1 - 2015/6/25

N2 - Objectives To investigate the clinical and cost-effectiveness of self-monitoring of coagulation status in people receiving long-term vitamin K antagonist therapy compared with standard clinic care. Design Systematic review of current evidence and economic modelling. Data sources Major electronic databases were searched up to May 2013. The economic model parameters were derived from the clinical effectiveness review, routine sources of cost data and advice from clinical experts. Study eligibility criteria Randomised controlled trials (RCTs) comparing self-monitoring versus standard clinical care in people with different clinical conditions. Self-monitoring included both self-management (patients conducted the tests and adjusted their treatment according to an algorithm) and self-testing (patients conducted the tests, but received treatment recommendations from a clinician). Various point-of-care coagulometers were considered.

AB - Objectives To investigate the clinical and cost-effectiveness of self-monitoring of coagulation status in people receiving long-term vitamin K antagonist therapy compared with standard clinic care. Design Systematic review of current evidence and economic modelling. Data sources Major electronic databases were searched up to May 2013. The economic model parameters were derived from the clinical effectiveness review, routine sources of cost data and advice from clinical experts. Study eligibility criteria Randomised controlled trials (RCTs) comparing self-monitoring versus standard clinical care in people with different clinical conditions. Self-monitoring included both self-management (patients conducted the tests and adjusted their treatment according to an algorithm) and self-testing (patients conducted the tests, but received treatment recommendations from a clinician). Various point-of-care coagulometers were considered.

U2 - 10.1136/bmjopen-2015-007758

DO - 10.1136/bmjopen-2015-007758

M3 - Article

VL - 5

JO - BMJ Open

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SN - 2044-6055

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ER -