Conort O, Siguret V, Bourdon O, Nazaraly S, Brignone M, Pons-Kerjean N, Houze S, Laribe Cage S, Berthet F, Golmard J-L, Brion F, Tilleul P
Service de pharmacie, hôpital Cochin, AP-HP, 27, rue du Faubourg-Saint-Jacques, 75679 Paris, France.
Service d'hématologie biologique, hôpital européen Georges-Pompidou, AP-HP, 75908 Paris, France; Inserm UMR-S-1140, faculté de pharmacie, université Paris Descartes, 75270 Paris, France.
Ann Pharm Fr. 2014 Jul;72(4):287-95. doi: 10.1016/j.pharma.2014.02.004. Epub 2014 Mar 27.
We developed a training program for pharmacy students aiming at supporting patients receiving vitamin K antagonists (VKAs). The objective was to estimate how the program impacts VKA-treated patient knowledge acquisition and/or improvement on their anticoagulant treatment.
Using dedicated tools, pharmacy students received education on VKA treatment. Once appointed to clinical wards of Assistance publique-Hôpitaux de Paris, they were in charge of evaluating patient's knowledge on VKA treatment before and after training. Evaluation was conducted using a face-to-face standardized interview (14-item questionnaire). A global score was calculated for each patient. An univariate and multivariate analysis was performed to identify potential variables influencing score result.
One hundred and seventy VKA-treated patients were recruited in seven hospitals for evaluation of their knowledge on VKA treatment and on clinical at risk situations. Before intervention, patients obtained an average score of 12.3±3.2 (maximum: 18). Factors significantly associated with the score were possession of a VKA information booklet, VKA treatment duration, treatment initiation and age. Fifty-two patients with a low score were further trained by the pharmacy student. After intervention, their initial score was improved significantly, from 9.9±3.3 to 13.5±2.3 (P<0.0001).
Increasing patient knowledge is a way to decrease the rate of adverse effects. This study demonstrates that patients with primary poor knowledge improved it significantly thanks to pharmacy students' intervention. This may contribute to lower the VKA-associated risk of adverse events and consequently to the improvement of patients quality of life and healthcare expenditures.
我们为药学专业学生制定了一项培训计划，旨在为接受维生素K拮抗剂（VKA）治疗的患者提供支持。目的是评估该计划如何影响接受VKA治疗的患者在抗凝治疗方面的知识获取和/或改善情况。
药学专业学生使用专用工具接受VKA治疗相关教育。一旦被分配到巴黎公立医院集团的临床病房，他们负责在培训前后评估患者对VKA治疗的知识。评估通过面对面标准化访谈（14项问卷）进行。为每位患者计算一个总体得分。进行单变量和多变量分析以确定影响得分结果的潜在变量。
在七家医院招募了170名接受VKA治疗的患者，以评估他们对VKA治疗及临床风险情况的知识。干预前，患者的平均得分为12.3±3.2（满分：18分）。与得分显著相关的因素包括拥有VKA信息手册、VKA治疗持续时间、治疗开始情况和年龄。52名低分患者由药学专业学生进一步培训。干预后，他们的初始得分显著提高，从9.9±3.3提高到13.5±2.3（P<0.0001）。
增加患者知识是降低不良反应发生率的一种方法。本研究表明，由于药学专业学生的干预，初始知识水平较差的患者的知识水平有了显著提高。这可能有助于降低与VKA相关的不良事件风险，从而改善患者的生活质量并降低医疗费用。
