Background: For patients with heart valve replacement, self-management can play an important role in controlling the patient's condition, therefore, the purpose of this review was to identify the aspects of self-management and its clinical outcomes in patients with heart valve replacement. Methods: We conducted a systematic review of peer-reviewed research literature focused on self-management in patients with heart valve replacement. The databases of PubMed, Scopus, and web of science were searched until May 2020 free from time and language limitation. Al documents were assessed for eligible articles by title or abstract according to the search strategy.The screening process of articles was conducted by two independent authors. The selected articles were checked regarding to inclusion and exclusion criteria.Results: Finally, 25 studies were considered in this systematic review. Self-management of these patients has prerequisites and requires appropriate training. Self-management in these patients is applicable in the aspects of Anticoagulation therapy self-management, INR self-testing, Low-dose INR Self-management, and Heart valve function self-monitoring. In this method, with better control of INR levels and Anticoagulation therapy, the incidence of complications will be reduced and patients will be able to diagnose functional disorders in the early stages by monitoring the function of valve, which will prevent the progression of complications. Conclusion: The results of this review clearing that self-management is applicable in the aspects of Anticoagulation therapy, INR control, low dose INR management, and monitoring of cardiac valve function and by improving care standards, it will improve the quality of treatment for these patients.

Introduction: For patients with heart valve replacement, self-management can play an essential role in the management of their condition. Aim: This review aimed to identify the aspects of self-management and its clinical outcomes in patients with heart valve replacement. Material and methods: In this systematic review, the peer-reviewed research literature on self-management of patients with heart valve replacement was assessed. Since May 2020, the PubMed, Scopus, and web of science databases were searched regardless of time and language limitations. The eligibility of the articles was assessed by title or abstract according to the search strategy. Article selection was applied regarding to inclusion and exclusion criteria. Also, article screening was conducted by 2 independent authors. Results: Twenty-five studies were considered in this systematic review. For inclusion, the self-management of patients had to have prerequisites, appropriate training, and be applicable in the aspects of anticoagulation therapy self-management, international normalized ratio (INR) self-testing, low-dose INR self-management, and heart valve function self-monitoring. In this method, through proper management of INR levels and anticoagulation therapy, the complications rate could be reduced and the patients would be able to diagnose functional disorders in the early stages by monitoring the valve function. This procedure was able to prevent the progression of complications. Conclusions: Self-management is an applicable protocol in the field of anticoagulation therapy, INR control, low-dose INR management, and the monitoring of cardiac valve function. This protocol could improve the quality of treatment for these patients through upgrading the care standards.

BackgroundPatients with mechanical heart valve due to the possibility of coagulation complications require lifelong use of anticoagulants and International Normalized Ratio (INR) control. But if not taken care of properly, anticoagulant therapy itself can put people at risk for bleeding and be life-threatening. ObjectivesThe aim of this study was to determine the effect of Self-care training and information support of patients with mechanical heart valve on INR and the bleeding complications.DesignA randomized double-blind controlled trial.Settings and MethodsParticipants were recruited via convenience sampling from Farshchian hospital in Hamadan, Iran; and were randomly divided into two groups control (n=80) and intervention (n=80). Participants in the control group received only routine training; in addition, the intervention group received 6 sessions of self-care training and 6 months of information support. Monthly the level of INR and incidence of bleeding were determined. Data were analyzed using independent t-test and chi-square in spss16 software at a significance level of 0.05.ResultsDuring 6 months of follow-up, except for the third month, the frequency of INR levels in therapeutic target range (2.5-3.5) in the intervention group was significantly higher than the control group (p<0.05). Also in the intervention group, the incidence of bleeding complications was relatively less than the control group, but this difference was not statistically significant (p>0.05).ConclusionProper self-care training and information support in patients with mechanical heart valve replacement have positive results. By doing self-care, the level of a therapeutic target range of INR maintained and the incidence of bleeding complications can be reduced.