Summary of findings 1. Self‐monitoring or self‐management of oral anticoagulation vs. standard care.
| Self‐monitoring or self‐management of oral anticoagulation vs. standard care | |||||
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Patient or population: Patients on long‐term anticoagulant therapy (treatment duration longer than two months) irrespective of the indication for treatment Settings: Primary care, specialist clinics (Europe, America, Canada) Intervention: Self‐monitoring or self‐management Comparison: Standard care | |||||
| Outcomes | Illustrative comparative risks* (95% CI) | Relative effect (95% CI) | No of Participants (studies) | Quality of the evidence (GRADE) | |
| Assumed risk | Corresponding risk | ||||
| Standard care | Self‐monitoring or self‐management | ||||
|
Thromboembolic events Follow‐up: 3 to 57 months |
Study population |
RR 0.58 (0.45 to 0.74) |
7594 (18 studies) |
⊕⊕⊕⊝ Moderate1 | |
| 35 per 1000 |
21 per 1000 (16 to 26) |
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| Moderate risk population | |||||
| 22 per 1000 |
12 per 1000 (10 to 16) |
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All‐cause mortality Follow‐up: 6 to 57 months |
Study population | RR 0.85 (0.71 to 1.01) | 6358 (11 studies) | ⊕⊕⊕⊝ Moderate1 | |
| 64 per 1000 | 54 per 1000 (45 to 64) | ||||
| Moderate risk population | |||||
| 0 per 1000 | 0 per 1000 (0 to 0) | ||||
|
Major haemorrhage Follow‐up: 4 to 57 months |
Study population |
RR 0.95 (0.80 to 1.12) |
8018 (20 studies) |
⊕⊕⊕⊝ Moderate1 | |
| 62 per 1000 |
59 per 1000 (50 to 69) |
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| Moderate risk population | |||||
| 18 per 1000 |
17 per 1000 (14 to 20) |
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Minor haemorrhage Follow‐up: 4 to 57 months |
Study population | RR 0.97 (0.67 to 1.41) | 5365 (13 studies) | ⊕⊕⊝⊝ Low2 | |
| 217 per 1000 | 210 per 1000 (145 to 306) | ||||
| Moderate risk population | |||||
| 45 per 1000 | 44 per 1000 (30 to 63) | ||||
| *The basis for the assumed risk (e.g. the median control group risk across studies) is provided in footnotes. The corresponding risk (and its 95% confidence interval) is based on the assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI). CI: Confidence interval; RR: Risk Ratio | |||||
| GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to that of the estimate of the effect. Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of the effect, but there is a possibility that it is substantially different. Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of the effect. Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect | |||||
1 Downgraded from high to moderate because of serious risk of bias.
2 Downgraded from high to low because of serious risk of bias and substantial heterogeneity.