Patient Self-Testing

PST patients performing 41 INR tests per person-year versus 8 in usual care experience shorter periods of subtherapeutic or supratherapeutic anticoagulation. PST effectively reduced both major haemorrhagic and thromboembolic complications compared with usual care. Patient self-management extends beyond PST by having patients control both monitoring and dosing decisions. Meta-analyses show both PST and PSM improve TTR, but only PSM had previously demonstrated improvement in thromboembolic outcomes. Prior RCTs that found no adverse event benefit for PST were limited because usual care control arms already achieved TTR above 60%, leaving little room for PST to show additional benefit. No multicentre RCT had evaluated PST in China or any other low- or middle-income country before this study. Patient self-testing has patients measure their own INR at home using a POCT device while a clinician or pharmacist retains responsibility for dose adjustment. The primary mechanism linking PST to improved clinical outcomes runs through testing frequency enabling earlier out-of-range detection and faster dose correction.