Oral anticoagulation therapy in children: successfully controlled by self-management
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Oral anticoagulation therapy in children : successfully controlled by self-management. / Christensen, Thomas Decker; Andersen, Niels Trolle; Maegaard, Marianne; Hansen, Ole Kromann; Hjortdal, Vibeke Elisabeth; Hasenkam, J Michael.
I: The Heart Surgery Forum, Bind 7, Nr. 4, 01.07.2004, s. E321-5.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Oral anticoagulation therapy in children
T2 - successfully controlled by self-management
AU - Christensen, Thomas Decker
AU - Andersen, Niels Trolle
AU - Maegaard, Marianne
AU - Hansen, Ole Kromann
AU - Hjortdal, Vibeke Elisabeth
AU - Hasenkam, J Michael
PY - 2004/7/1
Y1 - 2004/7/1
N2 - BACKGROUND: Children with congenital heart disease and who are on oral anticoagulation therapy present special challenges due to, for example, rapid fluctuations in international normalized ratio (INR) values, interruption in daily life due to frequent hospital/doctor visits, and difficulties and pain to the child in the performance of venipuncture. We hypothesize that oral anticoagulation therapy can be successfully controlled by self-management for this subset of patients. The aim of this study was to assess the treatment quality of self-managed oral anticoagulation therapy as the proportion of time within the therapeutic INR target range in children with congenital heart disease.METHODS: Children (N = 22) with a mean age of 10.6 years (range, 1.8-18.6 years) and their parents were trained in home blood analysis of INR and in coumarin dosage adjustment. After training, the children were monitored by weekly INR measurements. The therapeutic range in target INR values was +/-0.5. The indications for initiating oral anticoagulation therapy were the presence of a mechanical heart valve (n = 16) and total cavopulmonary connection (n = 6). The children had no physical restrictions.RESULTS: The mean observation time was 3.6 years (range, 0.9-5.8 years), and the total number of patient-years was 75.4. The patients were within the therapeutic INR target range for a median of 73.1% (range, 30.3%-91.0%) of the observation time. Two children died for reasons not related to the oral anticoagulation therapy. None of the patients experienced thromboembolic or bleeding complications requiring doctor intervention.CONCLUSION: Self-management of oral anticoagulation therapy is safe and provides a good quality of treatment for selected children with congenital heart disease.
AB - BACKGROUND: Children with congenital heart disease and who are on oral anticoagulation therapy present special challenges due to, for example, rapid fluctuations in international normalized ratio (INR) values, interruption in daily life due to frequent hospital/doctor visits, and difficulties and pain to the child in the performance of venipuncture. We hypothesize that oral anticoagulation therapy can be successfully controlled by self-management for this subset of patients. The aim of this study was to assess the treatment quality of self-managed oral anticoagulation therapy as the proportion of time within the therapeutic INR target range in children with congenital heart disease.METHODS: Children (N = 22) with a mean age of 10.6 years (range, 1.8-18.6 years) and their parents were trained in home blood analysis of INR and in coumarin dosage adjustment. After training, the children were monitored by weekly INR measurements. The therapeutic range in target INR values was +/-0.5. The indications for initiating oral anticoagulation therapy were the presence of a mechanical heart valve (n = 16) and total cavopulmonary connection (n = 6). The children had no physical restrictions.RESULTS: The mean observation time was 3.6 years (range, 0.9-5.8 years), and the total number of patient-years was 75.4. The patients were within the therapeutic INR target range for a median of 73.1% (range, 30.3%-91.0%) of the observation time. Two children died for reasons not related to the oral anticoagulation therapy. None of the patients experienced thromboembolic or bleeding complications requiring doctor intervention.CONCLUSION: Self-management of oral anticoagulation therapy is safe and provides a good quality of treatment for selected children with congenital heart disease.
KW - Administration, Oral
KW - Adolescent
KW - Anticoagulants/administration & dosage
KW - Child
KW - Child, Preschool
KW - Coumarins/administration & dosage
KW - Female
KW - Heart Defects, Congenital/complications
KW - Humans
KW - Infant
KW - Male
KW - Patient Compliance
KW - Self Administration/methods
KW - Thrombosis/etiology
KW - Treatment Outcome
U2 - 10.1532/HSF98.20041000
DO - 10.1532/HSF98.20041000
M3 - Journal article
C2 - 15454385
VL - 7
SP - E321-5
JO - Heart Surgery Forum
JF - Heart Surgery Forum
SN - 1098-3511
IS - 4
ER -
ID: 242781238