Smith Megan B, Christensen Nedra, Wang Shiquan, Strohecker Jennifer, Day John D, Weiss J Peter, Crandall Brian G, Osborn Jeffrey S, Anderson Jeffrey L, Horne Benjamin D, Muhlestein Joseph B, Lappe Donald L, Moss Heidi, Oliver Jessica, Viau Krista, Bunch T Jared
Department of Nutrition, Dietetics and Food Sciences, Utah State University, Logan, Utah, USA.
Cardiology. 2010;116(1):61-9. doi: 10.1159/000314936. Epub 2010 May 26.
Multiple factors influence warfarin metabolism and can significantly affect the risk of adverse events. The extent to which patients understand the modifiable factors that impact on warfarin safety and efficacy is unclear.
A 52-item questionnaire related to knowledge of warfarin was administered to patients with atrial fibrillation in a face-to-face interview with a dietitian. Results were compiled based on five categories: general warfarin knowledge, compliance, drug interactions, herbal or vitamin interactions, and diet.
100 patients were surveyed. Stroke risk factors included hypertension (57%), heart failure (36%), age >75 years (33%), diabetes (22%), and prior stroke/transient ischemic attack (29%). The majority were either high-school (49%) or college graduates (27%). Ten (10%) had a stroke while on warfarin, 11 (11%) had a blood transfusion, and 26 (26%) had at least one fall. The percentages correct for questionnaire items in the five categories were as follows: general knowledge (62%), compliance (71%), drug interactions (17%), herbal or vitamin interactions (7%), and diet (23%). Neither education level nor duration of therapy correlated with warfarin knowledge. Patients at highest risk of stroke had very low knowledge scores in general.
Patients on warfarin have a poor general understanding of the medication, particularly those at highest risk of stroke.
多种因素影响华法林的代谢，并可显著影响不良事件的风险。患者对影响华法林安全性和疗效的可改变因素的了解程度尚不清楚。
由营养师与房颤患者进行面对面访谈，使用一份包含52个项目的关于华法林知识的问卷。结果根据五个类别进行汇总：华法林一般知识、依从性、药物相互作用、草药或维生素相互作用以及饮食。
共调查了100名患者。中风危险因素包括高血压（57%）、心力衰竭（36%）、年龄>75岁（33%）、糖尿病（22%）以及既往中风/短暂性脑缺血发作（29%）。大多数患者为高中（49%）或大学毕业生（27%）。10名（10%）患者在服用华法林期间发生中风，11名（11%）患者接受了输血，26名（26%）患者至少跌倒过一次。五个类别的问卷项目正确回答率如下：一般知识（62%）、依从性（71%）、药物相互作用（17%）、草药或维生素相互作用（7%）以及饮食（23%）。教育水平和治疗持续时间均与华法林知识无关。一般而言，中风风险最高的患者知识得分很低。
服用华法林的患者对该药物的总体了解较差，尤其是中风风险最高的患者。
