Hasan Syed S, Shamala R, Syed Imran A, Basariah N, Chong David W K, Mei Teh K, Chin Ong H
Department of Pharmacy Practice, School of Pharmacy and Health Sciences, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia.
J Pharm Pract. 2011 Oct;24(5):485-93. doi: 10.1177/0897190011415684. Epub 2011 Aug 15.
To assess the anticoagulation knowledge and international normalized ratio (INR) control among patients on warfarin.
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.
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).
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.
评估服用华法林患者的抗凝知识及国际标准化比值（INR）控制情况。
采用横断面研究，从医生（非药物治疗依从性诊所[非MTAC]）和药剂师（MTAC）管理的抗凝诊所中随机抽取156例患者，使用经过验证的访谈式问卷进行调查。记录患者2008年至2010年的INR读数。
服用华法林的患者对华法林作用机制的知识平均得分为66.5%±36.0%，对华法林与酒精相互作用的知识平均得分为42.9%±44.9%，对不良反应的知识平均得分为49.2%±21.1%。MTAC患者和非MTAC患者在知识方面未发现显著差异。患者的知识与年龄呈负相关（P = 0.001，r(s)= -0.293），与教育水平呈正相关（P = 0.001，r(s)= 0.365）。在比较平均达标天数百分比（63.4%±18.9%对52.5%±18.2%；P = 0.006）和平均达标就诊百分比（58.8%±17.9%对46.8%±18.6%；P = 0.001）时，发现MTAC患者的INR控制优于非MTAC患者。
与非MTAC患者相比，MTAC患者的INR控制更好。医生、药剂师和护士之间应开展联合合作以实现理想的治疗效果。
