Warfarin Knowledge in Patients with Atrial Fibrillation: Implications for Safety, Efficacy, and Education Strategies

Smith, Megan B; Christensen, Nedra K.; Wang, Yunlong; Strohecker, J.; Day, John D.; Weiss, J. Peter; Crandall, Brian G.; Osborn, Jeffrey S.; Anderson, Jeffrey L.; Horne, Benjamin D.; Muhlestein, Joseph B.; Lappé, Donald; Moss, Heidi; Oliver, Jessica; Viau, Krista; Bunch, T. Jared

doi:10.1159/000314936

Cited by 64 publications

(71 citation statements)

References 54 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…12,13 The mean score in Hong Kong patients was much lower than UK patients (mean score 2.24 out of 4, P < 0.001) 12 and patients in Finland (mean score, 5.94 out of 8; P < 0.001). 13 Patients Knowledge of Warfarin Therapy: A total of 114 patients were recruited in this part of questionnaire, including the 70 patients who participated in the previous AF knowledge questionnaire and 44 patients without AF but who were using warfarin for stroke prevention. The demographics of patients are summarized in Table 3.…”

Section: Questionnaire For Patientsmentioning

confidence: 81%

“…We adopted the original questionnaire by Gattellari et al in English for the physicians. 11 The questionnaire for patients was designed based on 2 previously published surveys conducted in the United Kingdom 12 and Finland, 13 and translated into the traditional Chinese version and validated.…”

Section: Methodsmentioning

confidence: 99%

“…12 Compared to patients in Finland, more Hong Kong patients (70%) did exercise normally during AF than for patients in Finland (35%), 13 but fewer Hong Kong patients (<25%) knew the symptoms of AF than did patients in Finland (>80%). 13 When we compared the response from Hong Kong patients in questions from the UK survey (questions 1, 3, 6, and 7; maximum score of 4) and the Finland survey (questions 4, 9, 11, 12; maximum score of 8), the mean score of Hong Kong patient was 1.16 out of 4 and 2.77 out of 8, respectively. 12,13 The mean score in Hong Kong patients was much lower than UK patients (mean score 2.24 out of 4, P < 0.001) 12 and patients in Finland (mean score, 5.94 out of 8; P < 0.001).…”

Section: Questionnaire For Patientsmentioning

confidence: 99%

“…13 When we compared the response from Hong Kong patients in questions from the UK survey (questions 1, 3, 6, and 7; maximum score of 4) and the Finland survey (questions 4, 9, 11, 12; maximum score of 8), the mean score of Hong Kong patient was 1.16 out of 4 and 2.77 out of 8, respectively. 12,13 The mean score in Hong Kong patients was much lower than UK patients (mean score 2.24 out of 4, P < 0.001) 12 and patients in Finland (mean score, 5.94 out of 8; P < 0.001). 13 Patients Knowledge of Warfarin Therapy: A total of 114 patients were recruited in this part of questionnaire, including the 70 patients who participated in the previous AF knowledge questionnaire and 44 patients without AF but who were using warfarin for stroke prevention.…”

Section: Questionnaire For Patientsmentioning

confidence: 99%

See 3 more Smart Citations

Barriers to Warfarin Use for Stroke Prevention in Patients With Atrial Fibrillation in Hong Kong

Lee

Tam

Yan

et al. 2012

Clinical Cardiology

View full text Add to dashboard Cite

Background:Oral anticoagulation medications such as warfarin reduce the risk of stroke in atrial fibrillation (AF) but have been underutilized. This study aimed to investigate physicians' perceptions of stroke prevention management and patients' knowledge of AF and warfarin therapy in Hong Kong (HK).Hypothesis:Both physician and patient's knowledge on warfarin use were the barriers for stroke prevention in patients with atrial fibrillation in Hong Kong.Methods:This prospective survey‐based study was conducted between February 2011 and April 2011 to assess physicians' perceptions of stroke prevention management, patients' knowledge of AF, and patients' knowledge of warfarin therapy. The results were scored and compared with those in foreign countries.Results:Sixty‐two physicians and 114 warfarin users were recruited in the study. The average score of HK physicians in the knowledge of stroke prevention therapy in AF patients was lower than that of Australian (AUS) family physicians (HK 2.48 vs AUS 4.02 out of 7). The mean scores of AF patients in Hong Kong regarding the knowledge of AF were lower than that of United Kingdom (UK) (HK 1.16 vs UK 2.24 out of 4) (P < 0.001) and that of Finland (FIN) (HK 2.77 vs FIN 5.94 out of 8) (P < 0.001), respectively. The mean score of AF patients in Hong Kong regarding the knowledge of warfarin therapy was lower than that of AF patients in the United States (US) (HK 2.39 vs US 3.92).Conclusions:The barriers of warfarin use for AF patients in Hong Kong were related to both physicians and patients. Many Hong Kong physicians did not comply with international recommendations of stroke prevention in AF patients, and AF patients had a low knowledge level about the disease and warfarin therapy.Presented at the International Congress of Cardiology, Hong Kong, Peoples Republic of China, February 24‐26, 2012.This study was supported by the School of Pharmacy, the Chinese University of Hong Kong.The authors have no other funding, financial relationships, or conflicts of interest to disclose.

show abstract

Section: Questionnaire For Patientsmentioning

confidence: 81%

Section: Methodsmentioning

confidence: 99%

Section: Questionnaire For Patientsmentioning

confidence: 99%

Section: Questionnaire For Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Barriers to Warfarin Use for Stroke Prevention in Patients With Atrial Fibrillation in Hong Kong

Lee

Tam

Yan

et al. 2012

Clinical Cardiology

View full text Add to dashboard Cite

show abstract

“…Pacjenci często nie mają jednak odpowiedniej wiedzy na temat AF -nawet ci, którzy otrzymali ustne i pi- semne informacje [32,1011,1012], co wskazuje na potrzebę dalszego rozwoju usystematyzowanej edukacji pacjentów. Opracowano kilka narzędzi do informowania pacjentów, koncentrujących się głównie na OAC [1013][1014][1015][1016]. Grupa robocza autorów niniejszych wytycznych opracowała specjalną aplikację dla pacjentów z AF w celu wsparcia ich informowania i edukowania.…”

Section: Zintegrowana Edukacja Pacjentówunclassified

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

2,399

4,206

View full text Add to dashboard Cite

Rebuttal: Response to a letter about the cardioseal device

Tobis

2009

Cathet Cardio Intervent

View full text Add to dashboard Cite

Rebuttal: Response to a Letter About the CardioSeal Device TO THE EDITOR I welcome this controversy from my esteemed colleagues. As members of the Editorial Board for Catheterization and Cardiovascular Interventions, we are asked to provide editorials that demonstrate our opinion about a topic raised by the articles published. The purpose is to flush out the details and nuances beyond the data that can be described in a paper.My observation is that interventional cardiologists are not preselected for timid qualities. The authors of these letters have strong opinions about the devices described for ASD or PFO closure. As an experienced operator, I have my own opinions which I expressed in the editorial, suggesting that, ''The CardioSeal/Starflex device should be graciously retired.'' I'm glad to see that my comments stimulated this discussion. It raises questions that all operators can think about when they are trying to decide what equipment is best for their patients.Perhaps I was too subtle in my editorial so that my friends who wrote these letters did not completely understand my points. Let me summarize them here:1. The CardioSeal/Starflex device is not an adequate self centering device and is not an optimal ASD closure device. In most operators' experience, the Amplatzer device is much more effective for closing ASDs. 2. As for closure of PFOs, all of the devices are being used off label without FDA approval. We should make every effort to enroll appropriate patients in the randomized trials for stroke or migraine. 3. There is a 20% incidence of thrombus on the CardioSeal device at 2-4 weeks post implantation. 4. There is a 3% stroke or embolic event rate when the CardioSeal is used for PFO closures. Perhaps some of these emboli are due to atherosclerotic disease, perhaps not. It is impossible to know, but the fact that there is a high frequency of documented thrombus on the device makes me more suspicious that the device is the source of emboli rather than the ascending aorta. 5. The CardioSeal/Starflex is a poor PFO closure device. If the tunnel is long, the arms of the umbrella often force the PFO to open more than it was before. This might explain some of the alleged 35% residual shunt rate in the MIST Trial. 6. The company that makes this device and sponsored the MIST trial, NMT, is suing the original cardiology principal investigator, Peter Wilmshurst, in an effort to silence his criticisms. In my 35 years in academic medicine, I've never heard of such an egregious attempt to suppress scientific dialogue. Perhaps with a new CEO now at NMT, they will drop this self-detrimental lawsuit. Until the 6 month echo data for frequency and severity of residual shunts is clarified from the MIST trail, we will be left with uncertainty about this device. This has lead to the assumption from the neurology community that PFO closure does not reduce migraine frequency and inhibits their interest in entering patients into ongoing clinical trials. Until the effectiveness for complete closure with the CardioSeal is known...

show abstract

Warfarin Knowledge in Patients with Atrial Fibrillation: Implications for Safety, Efficacy, and Education Strategies

Cited by 64 publications

References 54 publications

Barriers to Warfarin Use for Stroke Prevention in Patients With Atrial Fibrillation in Hong Kong

Barriers to Warfarin Use for Stroke Prevention in Patients With Atrial Fibrillation in Hong Kong

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Rebuttal: Response to a letter about the cardioseal device

Contact Info

Product

Resources

About