Effect of Self-Management Program on Self-efficacy and Medication Adherence in Patients with Mechanical Heart Valve: a Randomized Clinical Trial

Abstract

Introduction:Patients with mechanical heart valve need anticoagulant therapy to prevent thrombotic events. The treatment interacts with some foods and drugs. The aim was to evaluate the effect of self-management program on self-efficacy and medication adherence in patients with mechanical heart valve. Methods: This was a randomized controlled trial. eighty eligible patients, with the ability to read and speak in Farsi, aged between 15 to 60, were included in the study from the cardiac surgery clinic in Imam Khomeini hospital affiliated to Tehran University of Medical Sciences (Tehran, Iran) and randomly allocated to intervention and control groups. The participants had no history of psychiatric disorders, had undergone valve replacement surgery at least one year before the study, and were being treated with Warfarin. The intervention was a combination of 2 one-hour selfmanagement education via small groups with 3 to 5 members, self-management educational booklets, and weekly call follow-ups for 8 weeks about 10-15 minutes. The control group received no intervention. Self-efficacy was the primary outcome and medication adherence, Prothrombin Time (PT), and International Normalized Ratio (INR) were secondary outcomes. Data were analyzed using SPSS13. Results: Although the mean of self-efficacy and medication adherence, PT, and INR values were not different between the two groups at baseline, they improved significantly following the program. Conclusion: Self-management program had a positive effect on self-efficacy and medication adherence of patients with mechanical heart valve.Citation: Javan L, kazemnejad K, Nomali M, Zakerimoghadam M. Effect of self-management program on self-efficacy and medication adherence in patients with mechanical heart valve: a randomized controlled trial.

The Effects of Educational Programs on Knowledge, International Normalized Ratio, Warfarin Adherence, and Warfarin-Related Complications in Patients Receiving Warfarin Therapy

“…Among the included studies, 8 studies demonstrated positive effects on the defined outcomes 43,44,46–51 . Verbal education was adopted in all effective educational programs.…”

“…The frequency and duration of lectures varied among effective studies. Six studies 43,44,46–48,51 conducted 1 session, whereas 1 study 50 conducted 2 sessions. The mean duration of each lecture differed among studies, with a lecture duration of 15 minutes in 1 study, 51 30 minutes in 1 study, 48 45 minutes in 3 studies, 43,44,46 and 60 minutes in 2 studies 47,50 .…”

“…Six studies 43,44,46–48,51 conducted 1 session, whereas 1 study 50 conducted 2 sessions. The mean duration of each lecture differed among studies, with a lecture duration of 15 minutes in 1 study, 51 30 minutes in 1 study, 48 45 minutes in 3 studies, 43,44,46 and 60 minutes in 2 studies 47,50 . Jackson et al 49 educated patients during 4 home visits, of which the average visit time was 24 minutes.…”

“…The age of participants was generally older than 60 years in 7 studies. 43,44,[47][48][49]51,52 Despite the education levels of participants being unreported in 2 studies, 49,52 Javan et al 50 reported that more than one-third of the participants were at the educational stage of elementary school, 2 studies 47,48 revealed that participants' mean years of education was 10, whereas 4 studies 43,44,46,51 indicated that more than 60% of participants were at the stages of primary education or lower. The included studies were implemented in diverse countries: 1 study in the United States, 1 in the United Kingdom, 1 in Australia, 2 in Croatia, 1 in Israel, 1 in Iran, 1 in Turkey, and 1 in China.…”

“…The mean duration of each lecture differed among studies, with a lecture duration of 15 minutes in 1 study, 51 30 minutes in 1 study, 48 45 minutes in 3 studies, 43,44,46 and 60 minutes in 2 studies. 47,50 Jackson et al 49 educated patients during 4 home visits, of which the average visit time was 24 minutes. Because education was part of the home visit, the exact duration could not be determined.…”