Alphonsa Annu, Sharma Kamlesh K, Sharma Gautam, Bhatia Rohit
College of Nursing, All India Institute of Medical Sciences, New Delhi, India.
Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
J Stroke Cerebrovasc Dis. 2015 Mar;24(3):668-72. doi: 10.1016/j.jstrokecerebrovasdis.2014.11.007. Epub 2015 Jan 7.
Apart from atrial fibrillation, indications for oral anticoagulation common in our clinical practice include rheumatic heart disease and mechanical heart valve replacement. Evaluation of current patient knowledge regarding oral anticoagulation therapy (OAT) is the first step in improving the quality of anticoagulation therapy and patient care. The aim of the present study was to assess the knowledge regarding OAT among patients with stroke and those at high risk of thromboembolic events in a tertiary care hospital in India.
A descriptive cross-sectional design was used; 240 patients on OAT because of various indications (mechanical heart valve replacement, rheumatic heart disease, atrial fibrillation, and stroke) attending the neurology and cardiology outpatient clinics and inpatient services were recruited. A structured self-developed questionnaire was used to assess the knowledge in these patients.
Most patients (62.9%) were ignorant about the target prothrombin time/international normalized ratio (PT/INR) levels with only 30% having their recent INR within the target range; 50% of the patients had a poor knowledge score, and the knowledge gap was most prominent in the domains of dietary interactions followed by drug interactions, adverse effects, and PT/INR monitoring. Knowledge score also had a significant association with gender, education, monthly income, and place of residence (P < .05).
Patient's knowledge about OAT was suboptimal. The findings support the need for educational interventions to improve the knowledge regarding OAT and, thereby, achieve an appropriate and safe secondary prevention of stroke.
除心房颤动外，在我们的临床实践中，口服抗凝治疗的常见适应证包括风湿性心脏病和机械心脏瓣膜置换术。评估当前患者关于口服抗凝治疗（OAT）的知识是提高抗凝治疗质量和患者护理水平的第一步。本研究的目的是评估印度一家三级护理医院中中风患者及血栓栓塞事件高危患者对OAT的了解情况。
采用描述性横断面设计；招募了240名因各种适应证（机械心脏瓣膜置换术、风湿性心脏病、心房颤动和中风）而接受OAT治疗的患者，这些患者来自神经内科和心内科门诊及住院部。使用一份自行编制的结构化问卷来评估这些患者的知识水平。
大多数患者（62.9%）对目标凝血酶原时间/国际标准化比值（PT/INR）水平一无所知，只有30%的患者最近的INR在目标范围内；50%的患者知识得分较低，知识差距在饮食相互作用领域最为突出，其次是药物相互作用、不良反应和PT/INR监测。知识得分还与性别、教育程度、月收入和居住地点显著相关（P < .05）。
患者对OAT的了解情况欠佳。这些发现支持了开展教育干预措施的必要性，以提高对OAT的了解，从而实现对中风的适当且安全的二级预防。
