Training for patients in a randomised controlled trial of self management of warfarin treatment
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《英国医生杂志》
1 Department of Primary Care and General Practice, Medical School, University of Birmingham, Birmingham B15 2TT
Correspondence to: E Murray e.t.murray@bham.ac.uk
Introduction
Although we used a training programme to train 242 unselected patients successfully in self management of warfarin treatment, 76% (1978/2586) of patients invited chose not to undertake self management and may therefore not consider this a desirable option. To our knowledge this is the first UK trial that invited unselected patients to self manage warfarin and as such may give a real indication of expected uptake. For patients keen to undertake self management three quarters were able to complete training. These patients considered it a convenient and valuable method of controlling their own health and most were enthusiastic to continue after the trial. If self management by patients is to become established standardisation and dissemination of training are needed, accompanied by practical guidelines to encourage back up from clinicians.
Contributors: EM managed the study, drafted the paper, and is a lead investigator. DF is principal investigator and critically revised the paper. DMcC and CF were research associates involved in field work, training, and assessing patients' data collection and management, and both reviewed the paper. HS produced the databases supported data cleaning and analysis and reviewed the paper. EM and DF are the guarantors.
Funding: Medical Research Council.
Competing interests: EM and DF have been reimbursed by Roche Diagnostics for attending several conference and to support educational programmes within the University of Birmingham's Department of Primary Care.
Ethical approval: Midland Research Ethics Committee.
References
Fitzmaurice DA, Murray ET, Gee KM, Allan TF, Hobbs FDR. A randomised controlled trial of patient self-management of oral anticoagulation treatment compared with primary care management. J Clin Pathol 2002;55: 845-9.
Fitzmaurice DA, Machin SJ. Recommendations for patients undertaking self management of oral anticoagulation. BMJ 2001;323: 985-9.
Sawicki PT. A structured teaching and self-management program for patients receiving oral anticoagulation. A randomized controlled trial. JAMA 1999;281: 145-50.
Morsdorf S, Erdlenbruch W, Taborski U, Schenk JF, Erdlenbruch K, Novotny-Reichert G, et al. Training of patients for self management of oral anticoagulant therapy: standards, patient suitability and clinical aspects. Semin Thromb Hemost 1999;25: 109-15.(Ellen Murray, MRC researc)
Correspondence to: E Murray e.t.murray@bham.ac.uk
Introduction
Although we used a training programme to train 242 unselected patients successfully in self management of warfarin treatment, 76% (1978/2586) of patients invited chose not to undertake self management and may therefore not consider this a desirable option. To our knowledge this is the first UK trial that invited unselected patients to self manage warfarin and as such may give a real indication of expected uptake. For patients keen to undertake self management three quarters were able to complete training. These patients considered it a convenient and valuable method of controlling their own health and most were enthusiastic to continue after the trial. If self management by patients is to become established standardisation and dissemination of training are needed, accompanied by practical guidelines to encourage back up from clinicians.
Contributors: EM managed the study, drafted the paper, and is a lead investigator. DF is principal investigator and critically revised the paper. DMcC and CF were research associates involved in field work, training, and assessing patients' data collection and management, and both reviewed the paper. HS produced the databases supported data cleaning and analysis and reviewed the paper. EM and DF are the guarantors.
Funding: Medical Research Council.
Competing interests: EM and DF have been reimbursed by Roche Diagnostics for attending several conference and to support educational programmes within the University of Birmingham's Department of Primary Care.
Ethical approval: Midland Research Ethics Committee.
References
Fitzmaurice DA, Murray ET, Gee KM, Allan TF, Hobbs FDR. A randomised controlled trial of patient self-management of oral anticoagulation treatment compared with primary care management. J Clin Pathol 2002;55: 845-9.
Fitzmaurice DA, Machin SJ. Recommendations for patients undertaking self management of oral anticoagulation. BMJ 2001;323: 985-9.
Sawicki PT. A structured teaching and self-management program for patients receiving oral anticoagulation. A randomized controlled trial. JAMA 1999;281: 145-50.
Morsdorf S, Erdlenbruch W, Taborski U, Schenk JF, Erdlenbruch K, Novotny-Reichert G, et al. Training of patients for self management of oral anticoagulant therapy: standards, patient suitability and clinical aspects. Semin Thromb Hemost 1999;25: 109-15.(Ellen Murray, MRC researc)