For selected and successfully trained patients, selfmonitoring is effective and safe for long-term oral anticoagulation therapy. Self-monitoring may enhance the quality of life for some patients who are frequently away from home, who are in employment or education, or those who find it difficult to travel to clinics. In general, patient selfmonitoring is unlikely to be more cost-effective than the current high-quality care provided by specialised anticoagulation clinics in the UK.