[Creation of a unit for education in the self-management of oat].

Abstract

Oral anticoagulant therapy (OAT) with Vitamin K antagonists requires frequent analytical controls that create a certain degree of dependency and a loss of autonomy in the patient. These drugs have an undesirable variability due to food and drug interactions, febrile processes, etc. which can modify the patient's INR and predispose them to a thromboembolic or hemorrhagic event. OAT self-control is supported by more than 15 years of experience in countries such as Germany and the Netherlands, and by comparative studies that reflect a reduction of thromboembolism and other adverse effects. The reason of this is because these patients are in the correct therapeutic range for longer periods of time due to more frequent controls (once a week against every 4-5 weeks of traditional control) and also to a better understanding of their treatment. In Aragon, OAT is a free health service and in our hospital, OAT has been an institutional aim since 2070. After a training course, the patient is capable to make their own INR determinations at home, to evaluate their results and adjust their own dose. Additionally the patient should acquire the appropriate knowledge to detect any adverse symptom and to know how to react to any problem in their treatment. This article summarizes our experience regarding the implementation of the programme and creation of the specific unit: the organization and training of the professionals involved, establishment of the patient selection criteria, and design of the patients' training course, follow-up strategy and equipment. In addition, the results of the study conducted in our Unit, showing a high degree of patient satisfaction, are included. At this moment 20% of our patients are included in the self-control strategy.