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Funding gap on self-care courses

Patients can manage their own warfarin treatment as effectively as doctors, but need an intensity of training the NHS cannot currently provide, a study has concluded.

Researchers warned the health service would only widen opportunities for self-management by investing in training and support.

Their study, published online by the Journal of Clinical Pathology, evaluated the effectiveness of self-management in 78 patients over 12 months.

Control of anticoagulation was at least as good in patients who self-managed as controls, with the time spent in the INR range measured at 70 and 64 per cent respectively. A follow-up study showed most patients were able to adhere to UK clinical guidelines for self-management and follow-up.

But self-managing patients needed training and the support of clinicians.

Project co-ordinator Deborah McCahon, at the department of primary care, University of Birmingham, said: 'Patients are able to test but there should be a designated clinician for advice on warfarin dosage.

'There are no training schemes. Anyone can buy a machine with a video showing how to test, but there's not much background about what to do with results.'

She added: 'I'm not suggesting patient self-management is suitable for everybody, but it does free up very busy clinics.'

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