Oral anticoagulant treatment in children based on monitoring at home

Aim: To evaluate the feasibility of home monitoring of oral anticoagulant treatment (OAT) in paediatric patients. Methods: A total of 19 paediatric patients received OAT and then monitored their treatment at home with CoaguChek(R). Data on their International Normalized Ratio (INR) values were collected retrospectively from hospital records and from the notes kept by the families. The families of the patients were also asked to fill in a questionnaire. Results: No thrombotic or haemorrhagic complications occurred during a total amount of 44.7 follow-up years. INR: the proportion of INR values measured at home falling within the therapeutic range for the given patient varied from 33 to 86% (median 69%). The questionnaire: all respondents were satisfied with home monitoring, and 63% felt that a major advantage of home monitoring was that there was no need to perform venipuncture. While 47% of the respondents reported no disadvantages of home monitoring, 42% reported that they occasionally lacked confidence in their ability to conduct OAT correctly at home. Conclusion: Home monitoring of OAT is feasible and reasonably reliable in paediatric patients. However, it is crucial that healthcare professionals supervise the treatment and the families are provided with detailed and precise instructions on how to act in a variety of clinical situations.