Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study

Yan, Connie H; Naveed, Maryam; Alobaidi, Ali; Kopfman, M.; Nutescu, Edith A.; Sharp, Lisa K.; Cannegieter, Suzanne C.

doi:10.1002/rth2.12605

Research and Practice in Thrombosis and Haemostasis

2021

DOI: 10.1002/rth2.12605

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Association between transportation barriers and anticoagulation control among an inner‐city, low‐income population: A prospective observational cohort study

Connie H Yan

Maryam Naveed

Ali Alobaidi

et al.

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“…If the hybrid model would result in fewer complications, then the spending gap would be further widened. [58][59][60][61] Therefore, INR self-testing and online consulting may be more economical in the long term. 43,62 Our study had some limitations.…”

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confidence: 99%

The Value of Anticoagulation Management Combining Telemedicine and Self-Testing in Cardiovascular Diseases: A Meta-Analysis of Randomized Controlled Trials

Huang¹,

Xie²,

Huang³

et al. 2023

TCRM

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No consensus has been established on the safety and effectiveness of out-of-hospital management of Vitamin K antagonists (VKA) therapy combining portable coagulometers and telemedicine. The present meta-analysis investigated the safety and effectiveness of this hybrid anticoagulants management model. Methods: The PubMed, Embase, Cochrane, and Web of Science databases were searched for papers published before May 1, 2022. To reduce bias, only randomized controlled trials were included. RevMan 5.3 (Cochrane) software was used to evaluate and analyze clinical outcomes, including the effectiveness and safety of patient management approaches, determined by the time in the therapeutic range (TTR) and occurrence of thrombotic and bleeding events. Results: Eight studies, comprising 3853 patients, were selected. The meta-analysis showed that anticoagulant management combining portable coagulometers and telemedicine significantly improved frequency of testing (mean difference [MD]= 12.95 days; 95% CI, 8.77-17.12; I 2 = 92%; P< 0.01) and TTR (MD= 9.50%; 95% CI, 3.16-15.85; I 2 = 87%; P< 0.01). Thromboembolism events were reduced (RR= 0.72; 95% CI, 0.51-1.01; I 2 = 0%; P= 0.05), but the results were not statistically significant. And no significant differences in major bleeding events, rehospitalization rate, mortality, or overall treatment cost existed between the two groups. Conclusion: Although the safety of remote cardiovascular disease management is not superior to that of conventional outpatient anticoagulant management, it provides a more stable monitoring of coagulation status.

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