The recommen- dation places a high value on avoiding the uncertainty in DOAC anticoagulant response associated with coadministration of the interacting drug and a low value on avoiding the burden of warfarin or LMWH therapy. Patients strongly adverse to INR monitoring or daily injections are likely to remain on DOACs, whereas avoiding DOACs in favor of VKA may be favored in the very elderly, those with compromised renal function, and situations where multiple drugs affecting P-gp and/or CYP enzymes are coprescribed. The panel identified the following additional research question. What are the patient-important outcomes associated with concomitant administration of DOACs with P-gp/CYP3A4 inhibitors/inducers compared with DOACs alone or compared with other anticoagulants coadministered with strong P-gp or Point-of-care INR testing Question: For patients receiving maintenance VKA therapy for treatment of VTE, should point-of-care INR testing by the patient at home (PST) vs any other INR testing approach be used? For patients receiving maintenance VKA therapy for treatment of VTE, the ASH guideline panel suggests using home point-of- care INR testing (PST) over any other INR testing approach except for PSM (see recommendation 4) in suitable patients (those who have demonstrated competency to perform PST and who can afford this option) (conditional recommendation based on low certainty in the evidence about effects ). Summary of the evidence. We found 1 systematic review that addressed this question,29 but this review included studies using both PST and PSM. For this specific question, we were interested only in PST and performed meta-analysis on this subset of studies. We included 11 studies measuring outcomes relevant to this question for patients performing PST.30-40 Studies included patients requiring VKA therapy for various indications, mainly for indications other than VTE treatment. 