Patient Self-Management of Anticoagulation: An Idea Whose Time Has Come

As the indications for the use of oral vitamin K antagonists in the treatment and prophylaxis of thromboembolic disorders increase, thromboembolic disorders are increasingly being recognized as chronic conditions in which high-quality chronic care management is essential for maximizing the net benefit of therapy (1). As envisioned in the chronic care model, optimal chronic care occurs when a “prepared proactive practice team interacts with an informed activated patient” (2). Inherent in this model is the concept of the patient–professional partnership as a new paradigm in which patients with chronic conditions, such as thromboembolic disorders, are their own caregivers and health care professionals are consultants supporting them in this role (3).

An integral component of this partnership is self-management education. This includes imparting not only necessary disease-specific information and technical skills but also problem-solving skills to allow patients to identify problems from their own point of view, form action plans, and implement solutions (4, 5). Self-management in the treatment of chronic thromboembolic disorders holds the promise of improving the quality of oral vitamin K antagonist …