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家庭医による家庭医のためのプライマリケア上達術 » 抗凝固療法のセルフモニタリング（自己監視）とセルフマネジメント（自己管理）

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抗凝固療法のセルフモニタリング（自己監視）とセルフマネジメント（自己管理）

抗凝固療法のセルフモニタリング（自己監視）とセルフマネジメント（自己管理）

http://www.aafp.org/afp/2011/0801/p266.html

コクランレビューから2010年のアップデート。抗凝固療法の中で特にワーファリンの長期投与が必要なケースは医学の進歩とともに増えてきた。そう中で問題となるのがワーファリンのコントロールである。ここ10年間で盛んに行われてきた研究分野にワーファリンのセルフモニタリングとセルフマネジメントというのがある。セルフモニタリングは自宅でINR を計測し結果をクリニックへ電話して用量を調整すること、セルフマネジメントは自宅で計測と用量と調節を自分ですることである。2006年のコクランのレビューではいまいちだったが、その後2010年の間にいくつかの RCT がさらに行われ今回、両方とも有効であると結果に結びついた。総死亡率を改善させる、出血を減少させる、血栓を減少させる、ということだ。おそらくこの結果を受けて欧米でもセルフモニタリングとセルフマネジメントが広く普及されることが予想される。日本でも早期の導入が望まれる。

update: 2011/08/10 | 家庭医プライマリケアアップデート
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