Wang Ye, Kong Ming Chai, Lee Lai Heng, Ng Heng Joo, Ko Yu
Department of Pharmacy, Faculty of Science, National University of Singapore, Singapore.
Department of Pharmacy, Singapore General Hospital, Singapore.
Thromb Res. 2014 Apr;133(4):550-4. doi: 10.1016/j.thromres.2014.01.002. Epub 2014 Jan 7.
A better understanding of patients' knowledge, satisfaction and concerns can identify deficits and help develop targeted patient education. This study aimed to examine patients' knowledge, satisfaction and concerns regarding warfarin therapy and assess their association with warfarin adherence and international normalized ratio (INR) control.
A cross-sectional survey was conducted in a convenience sample of patients taking warfarin in an anticoagulation clinic. The questionnaire consisted of questions on patients' knowledge, satisfaction and concerns regarding warfarin treatment. Patients' warfarin refill records and time within the therapeutic INR range were retrieved from hospital databases.
One hundred and eighty-three patients participated in the survey. Patients had inadequate knowledge of warfarin-diet and warfarin-drug interactions. Over 40% of the respondents were not satisfied with the waiting time to see a pharmacist. The most common concerns of taking warfarin were worries about warfarin-drug interactions (36.1%), forgetting to take warfarin (26.2%) and worries about side effects (25.7%). Higher satisfaction was associated with better knowledge (r=0.24, p=0.001) and fewer concerns (rs=-0.23, p=0.002). Better knowledge and higher satisfaction were associated with higher warfarin adherence (rs=0.21 and 0.16; p=0.01 and 0.046, respectively). Better knowledge, higher satisfaction, fewer concerns, and better warfarin adherence were associated with good INR control (p=0.003, 0.02, 0.03 and 0.003, respectively).
This study highlighted patients' concerns and deficits in knowledge regarding warfarin treatment, and also demonstrated their association with warfarin adherence and INR control.
更好地了解患者的知识、满意度和担忧可以发现不足之处，并有助于开展有针对性的患者教育。本研究旨在调查患者对华法林治疗的知识、满意度和担忧，并评估它们与华法林依从性及国际标准化比值（INR）控制之间的关联。
在一家抗凝门诊，对服用华法林的患者进行了便利抽样横断面调查。问卷包括有关患者对华法林治疗的知识、满意度和担忧的问题。从医院数据库中检索患者的华法林续方记录以及处于治疗性INR范围内的时间。
183名患者参与了调查。患者对华法林与饮食及华法林与药物相互作用的知识了解不足。超过40%的受访者对见到药剂师的等待时间不满意。服用华法林最常见的担忧是对华法林与药物相互作用的担心（36.1%）、忘记服用华法林（26.2%）以及对副作用的担心（25.7%）。更高的满意度与更好的知识水平相关（r = 0.24，p = 0.001），且担忧较少（rs = -0.23，p = 0.002）。更好的知识水平和更高的满意度与更高的华法林依从性相关（rs分别为0.21和0.16；p分别为0.01和0.046）。更好的知识水平、更高的满意度、更少的担忧以及更好的华法林依从性与良好的INR控制相关（p分别为0.003、0.02、0.03和0. .003）。
本研究突出了患者对华法林治疗的担忧和知识不足，同时也证明了它们与华法林依从性及INR控制之间的关联。
