Self-management of oral anticoagulation in children with congenital heart disease.

Abstract:

OBJECTIVE:The concept of self-management of oral anticoagulation has been shown to entail better quality of treatment than conventional management when assessed in selected adults. We have extended the concept of self-management to include children with congenital cardiac disease, hypothesizing self-management of oral anticoagulation is also possible in this subset of patients. Our aim was to assess the quality of self-management. METHODS:We trained 14 children aged from 2.2 to 15.6 years, with a mean age of 9.7 years, and their parents, in domiciliary analysis of the International Normalized Ratio and necessary adjustment of dosage of coumarin. The curriculum for training lasted for 27 weeks, and the patients and their parents were followed for a period of up to 31 months by weekly measurement of the values obtained for the International Normalized Ratio. RESULTS:The patients were observed over a mean of 547 days, with a range from 214 to 953 days. The patients were within the therapeutic targetted range of the International Normalized Ratio for a median of 65.5% of the time, with a range from 17.6% to 90.4%. None of the patients experienced thromboembolic or bleeding complications requiring doctoral intervention. All the patients and their parents expressed full satisfaction with the treatment. CONCLUSION:Self-management of oral anticoagulation provides a good quality of treatment, which is feasible and safe in selected children with congenital cardiac disease.

journal_name

Cardiol Young

journal_title

Cardiology in the young

authors

Christensen TD,Attermann J,Hjortdal VE,Maegaard M,Hasenkam JM

doi

10.1017/s1047951101000282

keywords:

subject

Has Abstract

pub_date

2001-05-01 00:00:00

pages

269-76

issue

3

eissn

1047-9511

issn

1467-1107

journal_volume

11

pub_type

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