A randomized controlled trial of shared care versus routine care for patients receiving oral anticoagulant therapy

Holm, Tine; Lassen, Jens Flensted; Husted, Steen; Christensen, Peter; Heickendorff, Lene

doi:10.1046/j.1365-2796.2002.01039.x

Cited by 23 publications

(9 citation statements)

References 29 publications

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“…Shared‐care models have been developed between primary care providers and specialists in the chronic management of diabetes (Holm, Lassen, Husted, Christensen, & Heickendorff, 2002), coagulation therapy (Renders et al, 2003), and congestive heart failure (Diller, Smucker, & David, 1999). Within this model of care, both the specialist and primary care provider have distinct roles in patient care and disease management (Oeffinger & McCabe, 2006; Smith, Allwright, & O’Dowd, 2007).…”

Section: Primary Care Approaches To Survivorship Carementioning

confidence: 99%

The primary care nurse practitioner and cancer survivorship care

Cooper¹,

Loeb

Smith

2010

Journal of the American Academy of Nurse Practitioners

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Section: Primary Care Approaches To Survivorship Carementioning

confidence: 99%

The primary care nurse practitioner and cancer survivorship care

Cooper¹,

Loeb

Smith

2010

Journal of the American Academy of Nurse Practitioners

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“…dabigatran [10]. There are different methods of managing OAT, including routine care (provided by the general practitioner), hospital outpatient clinics, highly specialized anticoagulation clinics, shared care, use of computer‐assessed dosage, patient self‐testing (PST), and patient self‐management (PSM) [1,11–13]. PSM in OAT means that the patient analyzes a drop of blood with a portable POCT coagulometer (INR monitor).…”

Section: Introductionmentioning

confidence: 99%

Precision and accuracy of point‐of‐care testing coagulometers used for self‐testing and self‐management of oral anticoagulation therapy

Christensen

Larsen

2012

Journal of Thrombosis and Haemostasis

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To cite this article: Christensen TD, Larsen TB. Precision and accuracy of point-of-care coagulometers used for self-testing and self-management of oral anticoagulation therapy. J Thromb Haemost 2012; 10: 251-60.Summary. Background: Oral anticoagulation therapy is monitored by the use of the International Normalized Ratio (INR). Patients who perform self-testing or self-management use a point-of-care testing (POCT) coagulometer (INR monitor) to estimate their INRs. A precondition for a correct dosage of coumarins is a correct INR estimation, and the method and apparatus used for providing the INR measurements are crucial in this context. Several studies have been published regarding the precision and accuracy of these POCT coagulometers, and have led to diverse conclusions. It is difficult and challenging to perform an overview of the literature, owing to the vast amount of papers, with differences in design, statistical analysis, etc. Objectives: The aim of this systematic review was to analyze the current literature, especially regarding the precision and accuracy of the POCT coagulometers, to provide recommendations for clinical use and quality control, and to point out areas for future research. Methods: We included a total of 22 studies, of which four were characterized as high-quality studies. Results: The precision of the POCT coagulometers was generally adequate for clinical use. Their performance in terms of accuracy has to be viewed in the context of the inherent inaccuracies of INR measurements. Conclusions: The accuracy of POCT coagulometers seems, in this respect, to be generally acceptable, and they can be used in a clinical setting.

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“…Simply stated, shared care refers to the care of a patient that is shared by two or more different specialties (or systems that are separated by some boundaries). The Shared-Care Model has been demonstrated to improve patient outcomes and enhance the management of patients with various chronic diseases including diabetes [48] and chronic renal disease [49], as well as those receiving oral anticoagulant therapy [50]. The cornerstone of shared care is communication and a period of transfer of knowledge between the specialist (e.g.…”

Section: Physician-directed Interventionmentioning

confidence: 99%

Technology-enabled activation of skin cancer screening for hematopoietic cell transplantation survivors and their primary care providers (TEACH)

et al. 2020

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Background: Hematopoietic cell transplantation (HCT) is a curative option for a growing number of patients with hematologic diseases and malignancies. However, HCT-related factors, such as total body irradiation used for conditioning, graft-versus-host disease, and prolonged exposure to immunosuppressive therapy, result in very high risk for melanoma and non-melanoma skin cancer (NMSC). In fact, skin cancer is the most common subsequent neoplasm in HCT survivors, tending to develop at a time when survivors' follow-up care has largely transitioned to the primary care setting. The goal of this study is to increase skin cancer screening rates among HCT survivors through patient-directed activation alone or in combination with physician-directed activation. The proposed intervention will identify facilitators of and barriers to risk-based screening in this population and help reduce the burden of cancer-related morbidity after HCT. Methods/design: 720 HCT survivors will be enrolled in this 12-month randomized controlled trial. This study uses a comparative effectiveness design comparing (1) patient activation and education (PAE, N = 360) including text messaging and print materials to encourage and motivate skin examinations; (2) PAE plus primary care physician activation (PAE + Phys, N = 360) adding print materials for the physician on the HCT survivors' increased risk of skin cancer and importance of conducting a full-body skin exam. Patients on the PAE + Phys arm will be further randomized 1:1 to the teledermoscopy (PAE + Phys+TD) adding physician receipt of a portable dermatoscope to upload images of suspect lesions for review by the study dermatologist and an online course with descriptions of dermoscopic images for skin cancers. Discussion: When completed, this study will provide much-needed information regarding strategies to improve skin cancer detection in other high-risk (e.g. radiation-exposed) cancer survivor populations, and to facilitate screening and management of other late effects (e.g. cardiovascular, endocrine) in HCT survivors.

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A randomized controlled trial of shared care versus routine care for patients receiving oral anticoagulant therapy

Abstract: Abstract. Holm T, Lassen JF, Husted SE, Christensen P, Heickendorff L (Aarhus University Hospital, Aarhus, Denmark). A randomized controlled trial of shared care versus routine care for patients receiving oral anticoagulant therapy. J Intern Med 2002; 252: 322-331.

Cited by 23 publications

References 29 publications

The primary care nurse practitioner and cancer survivorship care

The primary care nurse practitioner and cancer survivorship care

Precision and accuracy of point‐of‐care testing coagulometers used for self‐testing and self‐management of oral anticoagulation therapy

Technology-enabled activation of skin cancer screening for hematopoietic cell transplantation survivors and their primary care providers (TEACH)

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