Should Patients Be Asked To Manage Their Own Anticoagulation Services?

Posted on Thursday 17th April 2008

A major conference run by the University of Birmingham will ask whether patients taking medication to reduce the risks of cardiovascular problems and thrombosis should be entrusted with managing their own treatment.

The Anticoagulation in Practice conference (April 17th – April 18th) will bring together more than 150 leading academic experts, clinical specialists and patients to discuss how best to manage treatment for the 1 UK million patients taking medication to manage atrial fibrillation or control the risk of having a stroke.

The event now in its third year includes input from four of the leading professional organisations involved in this area of work - Anticoagulation Europe, the Anticoagulation Specialist Association, the Primary Care Cardiovascular Society, and CLOT.

Prescriptions of warfarin have increased rapidly in recent years as clinicians have realised its potential for stroke prevention.

However, there remains considerable disagreement about whether anti-coagulation management is best delivered through hospital out-patient clinics, general practice, pharmacies or through self management by patients.

Self management would require patients to measure the effects of drugs on the blood as well as taking regular medication.

Professor David Fitzmaurice comments: “More than 950,000 patients are currently taking warfarin to manage circulation problems, which amounts to 1% of people who regularly use GP services. 

This rapid increase in the use of anti-coagulation medication has placed significant pressure on hospital clinics and haematology services.

We felt it was important to bring together patients, clinicians and researchers to look at how these services can be managed cost effectively and safely for patients.

Currently there a wide range of services for patients including outpatient clinics, probably in part because there is no absolute agreement about the best solution. “

The keynote speaker Dr Artur Bernado will look at the experience in Europe, where more patients self manage their treatment. There will also be sessions on using warfrin in treating atrial fibrillation in the elderly and how the National Patient Safety Agency report has affected care.

Dr Ellen Murray, Research Fellow Department of Primary Care adds: “The health service has to face up to the rapidly increasing use of anticoagulation drugs – and find ways to make services effective.

There is still a need for more work to be done in assessing the different treatment models that could be used.

The largest trial of anticoagulation management run at Birmingham showed that patient self management was as clinically effective as routine care. However, the study also concluded that self management is actually poor value for money.

The question is whether taking 25% patients away from out-patient clinics by encouraging self management would allow clinicians to focus on the higher risk or more complicated cases”.

FURTHER INFORMATION

Ben Hill – Press Officer, University of Birmingham

tel: 0121 414 5134 / email: b.r.hill@bham.ac.uk / mob: 07789 921163

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