Department of Public Health, Ghent University, Ghent, Belgium.
Department of Cardiology, Cardiovascular Research Center Aalst, OLV Hospital Aalst, Aalst, Belgium.
J Adv Nurs. 2018 Nov;74(11):2577-2587. doi: 10.1111/jan.13780. Epub 2018 Aug 30.
This study aimed to: (a) determine adherence rates to oral anticoagulants in atrial fibrillation patients with a high risk for thromboembolic events postradiofrequency ablation; (b) evaluate patients' knowledge and perceptions towards oral anticoagulants; and (c) explore the impact of patients' knowledge and perceptions on treatment adherence.
Atrial fibrillation is a common arrhythmia associated with an increased risk of developing thromboembolic events such as stroke. Although adherence to oral anticoagulants is crucial to prevent such complications, the relationship between adherence, knowledge and patient perceptions is poorly understood in patients with atrial fibrillation at high risk for thromboembolic events after radiofrequency ablation.
A cross-sectional observational survey study was performed in a single centre.
The levels of adherence, knowledge, and perception towards oral anticoagulants were assessed using the 8-item Morisky Medication Adherence Scale, Knowledge of Oral Anticoagulation Tool, Perception of Anticoagulant Treatment Questionnaire and Benefit-Risk Perception Tool, respectively. Results from these self-reported tools were analysed descriptively. A multivariable binary logistic regression model was used to identify factors associated with levels of adequate adherence.
Adequate treatment adherence was found in three-quarters of patients. The total mean knowledge score was low. Participants expressed high ease of use and low burden of treatment. Higher total knowledge and satisfaction scores were significant factors associated with higher levels of adherence.
There remains a huge unmet need to follow-up and educate patients with atrial fibrillation, focusing on good knowledge and correct perception of the advantages and disadvantages of oral anticoagulants. Our results suggest that increased knowledge and satisfaction rates might have a positive impact on adherence to oral anticoagulants.
本研究旨在:(a)确定射频消融术后血栓栓塞事件高危的房颤患者口服抗凝剂的依从率;(b)评估患者对口服抗凝剂的知识和看法;(c)探讨患者的知识和看法对治疗依从性的影响。
房颤是一种常见的心律失常,与血栓栓塞事件(如中风)的风险增加有关。尽管口服抗凝剂的依从性对于预防此类并发症至关重要,但在射频消融术后血栓栓塞事件高危的房颤患者中,依从性、知识和患者看法之间的关系尚不清楚。
在一个中心进行了一项横断面观察性调查研究。
使用 8 项 Morisky 药物依从量表、口服抗凝剂知识工具、抗凝治疗感知问卷和获益-风险感知工具分别评估口服抗凝剂的依从性、知识和认知水平。这些自我报告工具的结果进行描述性分析。采用多变量二项逻辑回归模型确定与适当依从性水平相关的因素。
四分之三的患者有适当的治疗依从性。总的平均知识得分较低。参与者表示治疗的易用性高,负担低。较高的总知识和满意度得分是与较高依从性水平相关的重要因素。
仍有大量未满足的需求需要对房颤患者进行随访和教育,重点是提高对口服抗凝剂的优势和劣势的正确认识。我们的结果表明,知识和满意度的提高可能对口服抗凝剂的依从性产生积极影响。