The efficacy of self-managed oral anticoagulant therapy has been addressed in few randomized controlled trials, which have provided inconsistent results. The aim of this study was to compare the quality of self-managed oral anticoagulant therapy with conventional management. One hundred patients were randomly assigned to the two treatment regimens, and it was found that the quality of self-management of oral anticoagulant therapy was at least as good as the treatment provided by conventional management. Self-management is therefore a valid management option in selected patients.