Cochrane · systematic review · CD003839
Self‐monitoring and self‐management of oral anticoagulation
Heneghan, CJ, Garcia-Alamino, JM, Spencer, EA, et al. · Cochrane Database of Systematic Reviews · 2016 · Cochrane Library
HeartAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
12
current version
GRADE rated
12
No studies
0
Included studies
NR
No studies 0 · 0%Ungraded 0 · 0%Very low 0 · 0%Low 4 · 33.3%Moderate 8 · 66.7%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Self‐monitoring or self‐management of oral anticoagulation vs. standard care
Population: Patients on long‐term anticoagulant therapy (treatment duration longer than two months) irrespective of the indication for treatment
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Thromboembolic events Self‐monitoring or self‐management of oral anticoagulation vs standard care | RR 0.58 [0.45, 0.74] | 18 studies · 7594 participants | Moderate Downgraded: risk of bias |
All‐cause mortality Self‐monitoring or self‐management of oral anticoagulation vs standard care | RR 0.85 [0.71, 1.01] | 11 studies · 6358 participants | Moderate Downgraded: risk of bias |
Major haemorrhage Self‐monitoring or self‐management of oral anticoagulation vs standard care | RR 0.95 [0.8, 1.12] | 20 studies · 8018 participants | Moderate Downgraded: risk of bias |
Minor haemorrhage Self‐monitoring or self‐management of oral anticoagulation vs standard care | RR 0.97 [0.67, 1.41] | 13 studies · 5365 participants | Low Downgraded: risk of bias, inconsistency |
Self‐monitoring of oral anticoagulation vs. standard care
Population: Patients on long‐term anticoagulant therapy (treatment duration longer than two months) irrespective of the indication for treatment
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Thromboembolic events Self‐monitoring of oral anticoagulation vs standard care | RR 0.69 [0.49, 0.97] | 7 studies · 4097 participants | Moderate Downgraded: risk of bias, publication bias |
All‐cause mortality Self‐monitoring of oral anticoagulation vs standard care | RR 0.94 [0.78, 1.15] | 3 studies · 3300 participants | Moderate Downgraded: risk of bias, publication bias |
Major haemorrhage Self‐monitoring of oral anticoagulation vs standard care | RR 0.9 [0.74, 1.09] | 7 studies · 4038 participants | Low Downgraded: risk of bias, publication bias |
Minor haemorrhage Self‐monitoring of oral anticoagulation vs standard care | RR 1.16 [0.95, 1.42] | 6 studies · 3503 participants | Moderate Downgraded: risk of bias, publication bias |
self‐management of oral anticoagulation vs. standard care
Population: Patients on long‐term anticoagulant therapy (treatment duration longer than two months) irrespective of the indication for treatment
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Thromboembolic events self‐management of oral anticoagulation vs standard care | RR 0.47 [0.31, 0.7] | 11 studies · 3497 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
All‐cause mortality self‐management of oral anticoagulation vs standard care | RR 0.55 [0.36, 0.84] | 8 studies · 3058 participants | Moderate Downgraded: risk of bias, imprecision, inconsistency |
Major haemorrhage self‐management of oral anticoagulation vs standard care | RR 1.08 [0.79, 1.47] | 13 studies · 3980 participants | Low Downgraded: risk of bias, imprecision |
Minor haemorrhage self‐management of oral anticoagulation vs standard care | RR 0.91 [0.47, 1.76] | 7 studies · 1862 participants | Low Downgraded: risk of bias, imprecision, inconsistency |