OBJECTIVES: The purpose of the study was to evaluate the economic burden directly borne by the patient affected with Atrial Fibrillation, and the satisfaction associated with monitoring of Oral Anticoagulation Therapy (OAT) in different settings of care, in an Italian Region (Umbria). METHODS: A prospective, observational and multi-centre (5 centres: 3 anticoagulation clinics – ACs – and 2 usual settings of care – USCs) study was designed. Data were collected through case report forms created ad hoc. Study perspective was the patient's, thus the costs sustained by the Italian NHS were excluded, and only direct non-health care costs (out-of-pocket expenses covered either by the patient or by caregivers for non-health care related services) and patient's and caregiver's productivity losses were taken into account. Satisfaction with anticoagulation management was measured by the specific Duke Anticoagulation Satisfaction scale (DASS), together with the generic quality of life SF-36 form, both administered at day one and at the end of the observation period. RESULTS: A total of 101 patients in ACs and 51 in USCs were consecutively enrolled. The number of monitoring performed on a yearly basis resulted 3.5 tests less (-17%) for ACs compared to USCs (p-value 0.000), while the total time spent of each control was 7.1 hours less (-47%) for ACs (p-value 0.000). Direct non-health care costs and production losses per patients on a yearly basis amounted to an average of Euro 274.5 without significant differences amongst ACs and USCs. DASS in ACs resulted on average 0.5 points lower than USCs (p-value 0.001): patients in ACs felt less limitations on physical activities (-0,8 points, p-value 0,001), hassles (-1,0 points, p-value 0,000) and burdens (-0,6 points, p-value 0,001). The SF-36 did not detect any significant difference in the general health status. CONCLUSION: ACs appears to be the preferred setting of care for OAT monitoring when considering patient's perspective.