Literature DB >> 11779916

Ethnic differences in patient perceptions of atrial fibrillation and anticoagulation therapy: the West Birmingham Atrial Fibrillation Project.

Gregory Y H Lip1, Sridhar Kamath, Marian Jafri, Afzal Mohammed, David Bareford.   

Abstract

BACKGROUND AND
PURPOSE: We hypothesized that different ethnic groups would have different levels of knowledge and perceptions of atrial fibrillation (AF) and of their antithrombotic therapy. To investigate this further, we conducted a cross-sectional survey of patients with documented chronic AF who were attending the anticoagulation clinic in our city center teaching hospital, serving a multiethnic population.
METHODS: We surveyed 119 patients (77 male; mean age 69+/-9 years [mean+/-SD]); of these, 39 were Indo-Asian (33%), 27 Afro-Caribbean (23%), and 53 white (44%).
RESULTS: Only 63% of patients in the overall study cohort were aware of their cardiac condition, with Indo-Asians and Afro-Caribbeans significantly less aware of AF compared with the white patients (P<0.001). When questioned about the perception of the severity of the underlying condition, the majority (61%) felt that AF was "not serious." A large proportion were unaware that AF predisposed to thrombosis and stroke; among the ethnic groups, Indo-Asians appeared to be the least aware of the stroke and thromboembolic associations of AF. Only 52% in the whole cohort were aware of the reason(s) for commencing their warfarin, whereas the remainder began warfarin therapy simply because their "doctor told them to." Most patients in the whole cohort were aware of warfarin being used to prevent blood clots (65%) or stroke (66%), but Indo-Asians and Afro-Caribbeans were less so. Only 45% of the study cohort believed that there was some risk associated with warfarin therapy in the form of either "bleeding" or "poisoning." Only a minority of Indo-Asians and Afro-Caribbeans with AF felt that their doctor had given them enough information about their warfarin therapy, and many from these ethnic groups felt that they were careless about taking their warfarin.
CONCLUSIONS: In conclusion, many patients with AF possess very limited knowledge of AF as well as its consequences and therapy. In particular, our study has highlighted significant differences between different ethnic groups in terms of their knowledge of the risks, actions, and benefits of warfarin as well as of AF itself.

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Year:  2002        PMID: 11779916     DOI: 10.1161/hs0102.101817

Source DB:  PubMed          Journal:  Stroke        ISSN: 0039-2499            Impact factor:   7.914


  33 in total

Review 1.  Factors Affecting Patients' Perception On, and Adherence To, Anticoagulant Therapy: Anticipating the Role of Direct Oral Anticoagulants.

Authors:  Ekta Y Pandya; Beata Bajorek
Journal:  Patient       Date:  2017-04       Impact factor: 3.883

Review 2.  Oral anticoagulants for Asian patients with atrial fibrillation.

Authors:  Ian Sabir; Kaivan Khavandi; Jack Brownrigg; A John Camm
Journal:  Nat Rev Cardiol       Date:  2014-03-11       Impact factor: 32.419

3.  How good is anticoagulation control in non-valvar atrial fibrillation? Observations on the elderly, ethnicity, patient perceptions, and understanding of AF thromboprophylaxis.

Authors:  A Choudhury; G Y H Lip
Journal:  Heart       Date:  2005-04       Impact factor: 5.994

4.  Association of Race/Ethnicity With Oral Anticoagulant Use in Patients With Atrial Fibrillation: Findings From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation II.

Authors:  Utibe R Essien; DaJuanicia N Holmes; Larry R Jackson; Gregg C Fonarow; Kenneth W Mahaffey; James A Reiffel; Benjamin A Steinberg; Larry A Allen; Paul S Chan; James V Freeman; Rosalia G Blanco; Karen S Pieper; Jonathan P Piccini; Eric D Peterson; Daniel E Singer
Journal:  JAMA Cardiol       Date:  2018-12-01       Impact factor: 14.676

Review 5.  Warfarin therapy: in need of improvement after all these years.

Authors:  Stephen E Kimmel
Journal:  Expert Opin Pharmacother       Date:  2008-04       Impact factor: 3.889

6.  An international survey of physician and patient understanding, perception, and attitudes to atrial fibrillation and its contribution to cardiovascular disease morbidity and mortality.

Authors:  Etienne Aliot; Günter Breithardt; Josep Brugada; John Camm; Gregory Y H Lip; Panos E Vardas; Markus Wagner
Journal:  Europace       Date:  2010-05       Impact factor: 5.214

7.  Ethnic differences in patient perceptions of heart failure and treatment: the West Birmingham heart failure project.

Authors:  G Y H Lip; H Khan; A Bhatnagar; N Brahmabhatt; P Crook; M K Davies
Journal:  Heart       Date:  2004-09       Impact factor: 5.994

8.  Addressing barriers to optimal oral anticoagulation use and persistence among patients with atrial fibrillation: Proceedings, Washington, DC, December 3-4, 2012.

Authors:  Paul L Hess; Michael J Mirro; Hans-Christoph Diener; John W Eikelboom; Sana M Al-Khatib; Elaine M Hylek; Hayden B Bosworth; Bernard J Gersh; Daniel E Singer; Greg Flaker; Jessica L Mega; Eric D Peterson; John S Rumsfeld; Benjamin A Steinberg; Ajay K Kakkar; Robert M Califf; Christopher B Granger
Journal:  Am Heart J       Date:  2014-04-24       Impact factor: 4.749

Review 9.  Physicians' attitudes and the use of oral anticoagulants: surveying the present and envisioning future.

Authors:  Meghan York; Ashish Agarwal; Michael Ezekowitz
Journal:  J Thromb Thrombolysis       Date:  2003 Aug-Oct       Impact factor: 2.300

10.  Shared decision-making in atrial fibrillation: patient-reported involvement in treatment decisions.

Authors:  Fatima Ali-Ahmed; Karen Pieper; Rebecca North; Larry A Allen; Paul S Chan; Michael D Ezekowitz; Gregg C Fonarow; James V Freeman; Alan S Go; Bernard J Gersh; Peter R Kowey; Kenneth W Mahaffey; Gerald V Naccarelli; Sean D Pokorney; James A Reiffel; Daniel E Singer; Benjamin A Steinberg; Eric D Peterson; Jonathan P Piccini; Emily C O'Brien
Journal:  Eur Heart J Qual Care Clin Outcomes       Date:  2020-10-01
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