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

doi:10.1136/bmjopen-2015-007758

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

Research output: Contribution to journal › Article › peer-review

25 Citations (Scopus)

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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 language	English
Article number	e007758
Number of pages	15
Journal	BMJ Open
Volume	5
Issue number	6
Early online date	25 Jun 2015
DOIs	https://doi.org/10.1136/bmjopen-2015-007758
Publication status	Published - 25 Jun 2015

Bibliographical 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.

Access to Document

10.1136/bmjopen-2015-007758Licence: CC BY

Sharma BMJOpen 2015
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/
Final published version, 3.39 MBLicence: CC BY

Miriam Brazzelli
- School of Medicine, Medical Sciences & Nutrition, Health Services Research Unit (HSRU) - Personal Chair
- Institute of Applied Health Sciences
Person: Academic, Academic Related - Research
Craig Ramsay
- School of Medicine, Medical Sciences & Nutrition, Health Services Research Unit (HSRU) - Director of Health Services Research Unit
- Institute of Applied Health Sciences
Person: Academic
Graham Scotland
- School of Medicine, Medical Sciences & Nutrition, Health Economics Research Unit - Personal Chair
- Institute of Applied Health Sciences
Person: Academic

Influencing the introduction of self-monitoring coagulometers for NHS patients receiving longterm vitamin K antagonist therapy
Miriam Brazzelli (Coordinator), Pawana Sharma (Participant), Graham Scotland (Participant), Moira Cruickshank (Participant), Emma Maura Tassie (Participant), Cynthia Fraser (Participant), Christopher Burton (Participant) & Craig Ramsay (Participant)
Impact

Cite this

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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. ",

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{\textquoteright}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.",

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AU - Fraser, Cynthia

AU - Burton, Christopher David

AU - Croal, Bernard

AU - Ramsay, Craig R

AU - Brazzelli, Miriam Giovanna

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

Abstract

Bibliographical note

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Profiles

Miriam Brazzelli

Craig Ramsay

Graham Scotland

Impacts

Influencing the introduction of self-monitoring coagulometers for NHS patients receiving longterm vitamin K antagonist therapy

Cite this