Trial reportBMJ open2026
Evaluation of a pharmacist-led patient-self-testing model for warfarin management in patients undergoing mechanical heart valve replacement in China: a multicentre, open-label, randomised, controlled trial.
Trial report in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
1 citing paper in PubMed.
- Low-dose rivaroxaban versus warfarin in Asian patients after surgical bioprosthetic valve replacement: a propensity score-matched and inverse probability-weighted real-world study.Journal of thrombosis and thrombolysis · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesPatient self-testing (PST) for warfarin management is well-established in developed countries but remains underused in developing regions. This study compared the safety and effectiveness of PST with usual care (UC) in China.
designA multicentre, open-label, randomised, controlled trial.
settingA total of five centres participated in this study, including one provincial tertiary hospital, two municipal tertiary hospitals and two primary hospitals.
participantsPatients undergoing mechanical heart valve (MHV) replacement at five centres were prospectively enrolled. Patients were trained and stratified according to time on warfarin at enrolment and were randomly assigned to the PST or UC group.
interventionsThe PST group used a point-of-care testing device for at-home international normalised ratio (INR) monitoring with pharmacist-guided warfarin dosing, while the UC group attended outpatient clinics for INR monitoring and dosing. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was the difference in time in therapeutic range (TTR). The secondary outcomes were incidences of major bleeding, thromboembolism and all-cause deaths in 12 months.
resultsFrom March 2021 to March 2023, a total of 556 patients were enrolled, with a mean age of 47.5 years, 45.1% being male. 342 were newly initiating warfarin therapy, while 214 had been on warfarin for over 6 months. Baseline characteristics were similar between the PST and UC groups. The PST group showed significantly higher TTR (67.2% vs 55.1%, p<0.001) and lower incidences of major bleeding (0.7% vs 7.9%, p<0.001) and thromboembolism (0.4% vs 6.8%, p<0.001), with no difference in all-cause mortality (0.4% vs 1.8%, p=0.22). Logistic regression identified that using PST and younger age were independent factors associated with fewer warfarin-related adverse events.
conclusionsA pharmacist-led PST intervention with ongoing education and counselling led to improved TTR and clinical outcomes in patients with MHV in China. TRIAL REGISTRATION NUMBER: China Clinical Trial Registry (ChiCTR2000038984).
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