OBJECTIVES:  The objective of this study was to evaluate the uptake of anticoagulation self-testing among patients managed in U.S. anticoagulation clinics and to understand barriers and facilitators for patient self-testing (PST) as experienced by anticoagulation clinic providers. METHODS: A three-part survey was electronically distributed to 3,200 anticoagulation specialists affiliated with a US based anticoagulation clinic.  The survey included 41 questions and entailed a combination of both closed and open-ended items.  Closed-ended continuous and categorical data were analyzed to generate descriptive statistics via parametric and non-parametric testing.  Open-ended data were coded and thematically analyzed by three independent research team members who developed consensus on the top 3 themes for each question.  RESULTS: The survey response rate was 19% (N=605).  The uptake and incorporation of PST in practice has been gradual.  Between 2005 and 2015, there has been a 30% reduction in the preclusion of PST (from 57.4% to 27.4%).  While more clinics allow PST as a management option, the actual uptake and clinical adoption of PST has gradually decreased (29.1% (N=116) in 2012 vs. 1% (N=4) in 2015).  The uptake of PST in minority and underserved populations has been even more limited.  Opportunities to self-test are lower in practices that serve a greater proportion of minorities compared to those that serve largely non-minorities (56.6% vs. 75.8%, respectively; p=0.0001). The top three barriers to PST adoption identified by providers were patients’ limited cognitive ability, limited functional ability, and concern of patient reliability.  Respondents noted that interventions such as in-clinic/at-home training and competency assessment may alleviate barriers to clinical adoption of PST. CONCLUSIONS: While PST is known to result in improved anticoagulation control, implementation and clinical adoption in US based anticoagulation clinics has been lagging. This trend has been especially prominent in minority and underserved populations.