OBJECTIVES: To assess the anticoagulation knowledge and international normalized ratio (INR) control among patients on warfarin. METHODS: A cross-sectional study with 156 randomly sampled patients from physician- (non-medication therapy adherence clinic [non-MTAC]) and pharmacist (MTAC)-run anticoagulation clinics using a validated interviewer-administered questionnaire. Patients' INR readings from 2008 to 2010 were recorded. RESULTS: Patients on warfarin scored an average of 66.5% ± 36.0% for their knowledge on how warfarin works, 42.9% ± 44.9% for interaction between warfarin and alcohol, and 49.2% ± 21.1% for adverse effects. No significant differences were found between MTAC and non-MTAC patients on their knowledge. There was a negative correlation between patients' knowledge and age (P = .001, r (s) = -.293) and a positive correlation between patients' knowledge and education level (P = .001, r (s) = .365). MTAC patients were found to have better INR control than non-MTAC when compared for mean percentage days in range (63.4% ± 18.9% vs 52.5% ± 18.2%; P = .006) and mean percentage visits in range (58.8% ± 17.9% vs 46.8% ± 18.6%; P = .001). CONCLUSIONS: MTAC patients were found to have better INR control compared to non-MTAC patients. A joint cooperation between physicians, pharmacists, and nurses should exist to achieve desired therapeutic outcomes.
OBJECTIVES: To assess the anticoagulation knowledge and international normalized ratio (INR) control among patients on warfarin. METHODS: A cross-sectional study with 156 randomly sampled patients from physician- (non-medication therapy adherence clinic [non-MTAC]) and pharmacist (MTAC)-run anticoagulation clinics using a validated interviewer-administered questionnaire. Patients' INR readings from 2008 to 2010 were recorded. RESULTS:Patients on warfarin scored an average of 66.5% ± 36.0% for their knowledge on how warfarin works, 42.9% ± 44.9% for interaction between warfarin and alcohol, and 49.2% ± 21.1% for adverse effects. No significant differences were found between MTAC and non-MTAC patients on their knowledge. There was a negative correlation between patients' knowledge and age (P = .001, r (s) = -.293) and a positive correlation between patients' knowledge and education level (P = .001, r (s) = .365). MTAC patients were found to have better INR control than non-MTAC when compared for mean percentage days in range (63.4% ± 18.9% vs 52.5% ± 18.2%; P = .006) and mean percentage visits in range (58.8% ± 17.9% vs 46.8% ± 18.6%; P = .001). CONCLUSIONS: MTAC patients were found to have better INR control compared to non-MTAC patients. A joint cooperation between physicians, pharmacists, and nurses should exist to achieve desired therapeutic outcomes.
Authors: Jonathan P Piccini; Anne S Hellkamp; Yuliya Lokhnygina; Manesh R Patel; Frank E Harrell; Daniel E Singer; Richard C Becker; Günter Breithardt; Jonathan L Halperin; Graeme J Hankey; Scott D Berkowitz; Christopher C Nessel; Kenneth W Mahaffey; Keith A A Fox; Robert M Califf Journal: J Am Heart Assoc Date: 2014-04-22 Impact factor: 5.501
Authors: Marcus Fernando da Silva Praxedes; Mauro Henrique Nogueira Guimarães de Abreu; Saul Martins Paiva; Juliana Vaz de Melo Mambrini; Milena Soriano Marcolino; Maria Auxiliadora Parreiras Martins Journal: Health Qual Life Outcomes Date: 2016-06-24 Impact factor: 3.186