Safety relevant knowledge of orally anticoagulated patients without self-monitoring: a baseline survey in primary care

Abstract

BackgroundEffective and safe management of oral anticoagulant treatment (OAT) requires a high level of patient knowledge and adherence. The aim of this study was to assess patient knowledge about OAT and factors associated with patient knowledge.MethodsThis is a baseline survey of a cluster-randomized controlled trial in 22 general practices with an educational intervention for patients or their caregivers. We assessed knowledge about general information on OAT and key facts regarding nutrition, drug-interactions and other safety precautions of 345 patients at baseline.ResultsParticipants rated their knowledge about OAT as excellent to good (56%), moderate (36%) or poor (8%). However, there was a discrepancy between self-rated knowledge and evaluated actual knowledge and we observed serious knowledge gaps. Half of the participants (49%) were unaware of dietary recommendations. The majority (80%) did not know which non-prescription analgesic is the safest and 73% indicated they would not inform pharmacists about OAT. Many participants (35-75%) would not recognize important emergency situations. After adjustment in a multivariate analysis, older age and less than 10 years education remained significantly associated with lower overall score, but not with self-rated knowledge.ConclusionsPatients have relevant knowledge gaps, potentially affecting safe and effective OAT. There is a need to assess patient knowledge and for structured education programs.Trial registrationDeutsches Register Klinischer Studien (German Clinical Trials Register): DRKS00000586.Universal Trial Number (UTN U1111-1118-3464).

Predictors of warfarin non-adherence in younger adults after valve replacement surgery in the South Pacific

“…It is likely deficits in knowledge and understanding of warfarin therapy for all participants are underestimated, self-report notwithstanding 24. The largest study until now by Chenot et al ,24 evaluating safety-relevant knowledge of patients on warfarin found substantial gaps between how the patients rated themselves and actual measured knowledge.…”

“…The largest study until now by Chenot et al ,24 evaluating safety-relevant knowledge of patients on warfarin found substantial gaps between how the patients rated themselves and actual measured knowledge. For example, while almost all patients (95%) knew why they were on warfarin, 80% did not know which non-prescription analgesic was safe to take with warfarin, and 68% did not know they had warfarin-related dietary restrictions or considerations.…”

“…For example, while almost all patients (95%) knew why they were on warfarin, 80% did not know which non-prescription analgesic was safe to take with warfarin, and 68% did not know they had warfarin-related dietary restrictions or considerations. Importantly, many had a lack of awareness of the consequences of warfarin cessation and an understanding of the symptoms that indicated a likely stroke and thus the need for urgent medical attention, including paresis (74%) 24. Along with adherence to antithrombotic health self- management, patient's knowledge and safety-relevant understanding of warfarin therapy is considered critical in preventing life-threatening complications 17 25.…”

Real‐World Clinical Characteristics and Treatment Patterns of Individuals Aged 80 and Older with Nonvalvular Atrial Fibrillation: Results from the ReAl‐life Multicenter Survey Evaluating Stroke Study

“…In a subgroup analysis of the AFTER study including 631 individuals aged 75 and older, the rate of anticoagulant use was only 37%, and effective international normalized ratios (INR) levels were reached in only 38% . The optimal management of individuals taking OACs requires that they have a high level of knowledge and adherence, and previous studies have shown that older age is significantly associated with lower levels of knowledge about OAC therapy …”

“…7 The optimal management of individuals taking OACs requires that they have a high level of knowledge and adherence, and previous studies have shown that older age is significantly associated with lower levels of knowledge about OAC therapy. 8 The Awareness, Efficacy, Safety, and Time in Therapeutic Range of Warfarin in the Turkish Population (WARFARIN-TR) study was a multicenter prospective study of 4,987 Turkish individuals with AF using warfarin. 6 That study revealed that older age was associated with less awareness of warfarin; 35% of individuals aged 80 and older were aware of warfarin.…”