Anticoagulants are commonly used in clinical practice for both treatment as well as prevention of various illnesses. . The usual approach is initiation of anticoagulation with unfractionated heparin or low molecular  weight heparin followed by administration of  oral anticoagulants which include vitamin K antagonists(VKA). The therapeutic efficacy of VKAs is monitored by International normalized ration (INR) target range being 2-3 depending on the previous h/o any thrombotic events. Usual practice followed in India is clinic based monitoring of INR. The frequency of monitoring of INR varies from case to case but is usually daily till target INR is achieved followed by once every 02 weeks and if it is in therapeutic range then once every month. Whether the patient has been in effective anticoagulation during this period is assessed by time in therapeutic range (TTR)which is most commonly measured by Rosedaal method. There have been no studies in Indian settings assessing the efficacy of oral anticoagulation in patients on Vitamin K antagonists. There have been no studies in Indian settings assessing the effective anticoagulation.  Both subtherapeutic and supratherpeutic ranges of INR are detrimental to patient outcome ,Subtherapeutic exposing patient to increased risk of thrombotic events and supratherapeutic increasing the risk of major bleeding events. Hence it is of prime importance to maintain the INR in narrow therapeutic range. Also if SMS based reminders can improve adherence to regular INR testing and  the time therapeutic range it will obviate the need of an otherwise clinically stable patient to visit the hospital only for INR monitoring hence saving the time of clinician as well as the patient.