A 55-year-old woman with DVTs on a motoring holiday

Case scenario

A 55-year-old woman was spending her first year in retirement travelling around Australia in a campervan. After a hot dry spell in the central region early in the trip she developed DVTs in both legs and was appropriately treated with enoxaparin, then warfarin. She was initially told that she could cease warfarin after six months. However, the results of clotting tests showed that she was heterozygous for factor V Leiden polymorphism and anticardiolipin antibody positive. Should she continue with warfarin for the final four months of her trip, considering that she will be travelling through remote regions where it may be difficult to get regular INR estimations?