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Frequent monitoring of the international normalized ratio (INR) is necessary to ensure that patients who receive warfarin therapy stay within the drug's therapeutic range. Measuring the INR at home is convenient and, according to small studies, reduces rates of stroke and bleeding. However, home INR monitoring has not been established as being feasible, safe, and effective in large populations of patients with diverse backgrounds.
Now, investigators have compared self-testing with clinic testing in a large group of patients who received care at Veterans Affairs medical centers. The researchers randomized 2922 patients (98% men; 92% white) who were taking warfarin because they had mechanical heart valves or atrial fibrillation to either self-…