Summary of findings 3. self‐management of oral anticoagulation vs. standard care.
| Self‐management of oral anticoagulation vs. standard care | |||||
|
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‐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‐management | ||||
|
Thromboembolic events Follow‐up: 3 to 57 months |
Study population | RR 0.47 (0.31 to 0.70) | 3497 (11 studies) | ⊕⊕⊕⊝ Moderate2 | |
| 36 per 1000 | 17 per 1000 (12 to 25) | ||||
| Moderate risk population | |||||
| 16 per 1000 | 7 per 1000 (5 to 11) | ||||
|
All‐cause mortality Follow‐up: 6 to 57 months |
Study population | RR 0.55 (0.36 to 0.84) | 3058 (8 studies) | ⊕⊕⊕⊝ Moderate2 | |
| 33 per 1000 | 18 per 1000 (12 to 28) | ||||
| Moderate risk population | |||||
| 17 per 1000 | 9 per 1000 (6 to 14) | ||||
|
Major haemorrhage Follow‐up:4 to 57 months |
Study population | RR 1.08 (0.79 to 1.47) | 3980 (13 studies) | ⊕⊕⊝⊝ Low1 | |
| 33 per 1000 | 36 per 1000 (22 to 44) | ||||
| Moderate risk population | |||||
| 18 per 1000 | 19 per 1000 (14 to 26) | ||||
|
Minor haemorrhage Follow‐up: 4 to 57 months |
Study population | RR 0.91 (0.47 to 1.76) | 1862 (7 studies) | ⊕⊕⊝⊝ Low3 | |
| 137 per 1000 | 125 per 1000 (64 to 241) | ||||
| Moderate risk population | |||||
| 2 per 1000 | 2 per 1000 (1 to 4) | ||||
| *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 low because of serious risk of bias and imprecision of effect estimate.
2 Downgraded from high to moderate because of serious risk of bias.
3 Downgraded from high to low because of serious risk of bias and substantial heterogeneity.