Is anticoagulant therapy that is self-managed by a patient more beneficial for males patients than females patients?

This study compared the benefits of anticoagulant therapy between males and females who self-manage their treatment in a clinical practice. 

A stroke occurs when there is a disturbance of blood supply to a part of the brain. This can be caused by a blood clot in the brain (ischemic stroke) or a burst blood vessel (hemorrhagic stroke). Both types of stroke result in a lack of oxygen and food reaching the brain tissue and can cause brain damage.

Drugs that are often used to stop blood from clotting includes anticoagulants, such as warfarin (Coumadin). Warfarin requires regular monitoring to ensure that the right dose is being given. Too high a dose can increase the risk of bleeding such as after a fall or car crash. 

A new phenomenon, called patient self-management, allows trained patients to monitor and adjust their treatment themselves at home. However, it has been found that males benefit more than females when they manage their own treatment at home. 

This study compared the benefits of anticoagulant therapy between males and females who manage their own treatment in a clinical practice instead of at home. The occurrence of bleeding, blood clots, death were measured, as well as blood tests that make sure blood is within a therapeutic range where it is neither too thin or too clot-prone (therapeutic International normalized ratio (INR) target range) were recorded among both males and females. 

Among a total of 2,068 patients included in this study, men achieved a significantly better therapeutic INR target range, compared to females. Females spent 71% of the time within therapeutic INR target range, compared to 76% of males. However, the occurrence of death, bleeding, and blood clots were not significantly different between male and females. 

The study concluded that among patients that are trained to manage their own anticoagulant treatment, males achieved a better therapeutic INR target range, compared with women. However, there was no difference in the occurrence of blood clot complications between male and females. 

The patients in the study were relatively young and in good health. Therefore, the results should not necessarily be generalised to all patients receiving anti-blood clot drugs. 

If you or someone you know are receiving drugs to stop blood clots, and self-management treatment appeals to you, talk to a doctor about the benefits and risks of the self-management strategy and if it may suit you.