Remark: Those with score 0-2 are likely to achieve a good TTR. Those with score > 2 are less likely to achieve a good TTR and would require more regular INR checks, education/counseling and frequent follow- up, or alternatively, an NOAC should be considered as a better management option if high medication adherence can be expected. Monitoring Anticoagulant Therapy: Point-of-Care Testing: There is an increasing demand for oral anticoagulation among AF patients189 and not all patients are suitable for NOACs; therefore, a large proportion requires VKA which necessitates INR monitoring. Point-of-care testing using a coagulometer (INR monitor) is more convenient and time-ef cient, particularly where patient s self-monitor and/or self- manage. Home or clinic point-of-care monitoring is an increasingly standard method of INR monitoring associated with an appropriate degree of precision and accuracy for clinical practice190 ; however, routine calibration is warranted, and quality control systems should adhere with the Food and Drug Administration medical devices regulation guidance.191 Patient Self-Monitoring and Self-Management: A recent Cochrane review91 evaluating the effect of self-monitoring or self-management of OAC therapy compared with standard OAC monitoring on thromboembolic events, major bleeding, and death revealed a signi cant decrease in thromboembolic events in 18 studies) and with both self-monitoring (RR, 0.69; participants in 11 studies), although not all patients were AF. There was no overall reduction in the risk of death studies); however, self-management did reduce all-cause participants in 8 studies). Neither self-monitoring nor self-management reduced the risk of major bleeding compared with standard OAC monitoring (RR, 0.95; 95% CI, 0.80-1.12; 8,018 participants in 20 studies). Rating of the quality of evidence was low to moderate, and the ndings should be interpreted accordingly. 