The primary objectives of this systematic review were to: 1. Determine whether specialized anticoagulation clinics (ACC) are more effective and safer than care in non-specialized clinics (e.g., primary care clinics, physician offices) for management of long- term anticoagulation in adults; 2. Determine whether patient self testing (PST), either alone or in combination with patient self management (PSM), is more effective and safer than standard care; and 3. Identify the risk factors for serious bleeding in patients on chronic anticoagulant therapy.