Khudair Imran F, Hanssens Yolande I
Clinical Pharmacy Services, Pharmacy Department, Hamad General Hospital, Hamad Medical Corporation, PO Box 3050, Doha, Qatar.
Saudi Med J. 2010 Jun;31(6):672-7.
To evaluate the extent and quality of the patient's education on warfarin and its possible impact on the international normalized ratio (INR).
This is a cross-sectional study using a 20-item, self administered questionnaire of knowledge, offered to patients who were taking warfarin for at least 2 months and attending the medical or cardiology anticoagulation clinics in Hamad General Hospital, Hamad Medical Corporation, State of Qatar between August 2008 to November 2008.
A total of 140 patients completed the questionnaire, 116 patients (83%) reported that they received warfarin education and 61 patients (44%) had a controlled INR. Of the 79 patients with satisfactory knowledge (namely, overall score of at least 75%), 49 (62%) had a therapeutic INR compared with 12 (20%) having unsatisfactory knowledge (p<0.0001). The lowest scores were for participants' knowledge on the effects of a missing dose and its management (42%) and for warfarin drug interactions (36%).
An integrated and multidisciplinary education program may improve the patient's knowledge on warfarin as well as patient's compliance. This might lead to a better anticoagulation control, fewer clinic visits, and decrease in healthcare service load. Special attention should be addressed to geriatric patients and to those patients with low educational level and language barriers.
评估患者对华法林的了解程度和质量及其对国际标准化比值(INR)的可能影响。
这是一项横断面研究,采用一份由20个项目组成的关于知识的自填式问卷,提供给在2008年8月至2008年11月期间在卡塔尔国哈马德医疗公司哈马德总医院接受华法林治疗至少2个月且就诊于医学或心脏病学抗凝门诊的患者。
共有140名患者完成了问卷,116名患者(83%)报告他们接受了华法林教育,61名患者(44%)的INR得到控制。在79名知识掌握情况良好(即总分至少为75%)的患者中,49名(62%)的INR处于治疗范围内,而在知识掌握情况不佳的12名患者中这一比例为20%(p<0.0001)。得分最低的是参与者对漏服药物的影响及其处理的知识(42%)以及对华法林药物相互作用的知识(36%)。
一个综合的多学科教育项目可能会提高患者对华法林的了解以及患者的依从性。这可能会带来更好的抗凝控制、减少门诊就诊次数并降低医疗服务负担。应特别关注老年患者以及教育水平低和有语言障碍的患者。