Wang Xiaowu, Xu Bo, Liang Hongliang, Jiang Shuyun, Tan Hongmei, Wang Xinrong, Wang Xia, Yu Shiqiang, Liu Jincheng
Department of Cardiovascular Surgery, Xijing Hospital, Fourth Military Medical University, Xi'an 710032, Shaanxi, People's Republic of China,
Department of Health Statistics, Faculty of Preventive Medicine, Fourth Military Medical University, Xi'an 710032, Shaanxi, People's Republic of China.
Patient Prefer Adherence. 2018 Sep 3;12:1641-1648. doi: 10.2147/PPA.S172223. eCollection 2018.
Oral warfarin anticoagulation is a long-term treatment that is required after heart valve replacement. This treatment can prevent serious complications, such as embolism, thereby increasing patients' postoperative survival rates and quality of life. Patients treated with artificial mechanical heart valve replacement were followed up over the phone at different times after the procedure, which is an effective method for preventing accidents related to postoperative oral warfarin anticoagulation. Our goal was to determine a method for providing theoretical guidance to patients on oral warfarin anticoagulation following heart valve replacement.
The participants of this study were patients who received artificial mechanical heart valve replacements and were followed up for 2 years after the procedure. Patient adherence to medical advice was calculated, and the distribution characteristics of adherence to prescribed timing, prescribed dose, and regular clinical follow-up among patients of both sexes and of different ages, regions, and educational levels attained were compared.
Univariate and multifactorial logistic regression analyses were used to evaluate the factors influencing adherence. Our analyses showed that adherence to oral warfarin anticoagulation in patients after heart valve replacement is influenced by sex, age, residential location, and educational attainment. The medication habits of patients can be evaluated accordingly via phone follow-up. As such, dose adjustment recommendations can be provided, significantly increasing the adherence to oral warfarin anticoagulation in patients after heart valve replacement.
Adherence to oral warfarin anticoagulation among patients after heart valve replacement is affected by sex, age, type of residence, and educational level, as well as adherence to clinical follow-up over the phone. The follow-up sessions help establish good doctor-patient communication, which is critical for timely medication guidance, thus shortening medication administration delays and decreasing the overall length of therapy.
口服华法林抗凝是心脏瓣膜置换术后所需的长期治疗。这种治疗可预防严重并发症，如栓塞，从而提高患者术后生存率和生活质量。对接受人工机械心脏瓣膜置换术的患者在术后不同时间进行电话随访，这是预防术后口服华法林抗凝相关事故的有效方法。我们的目标是确定一种为心脏瓣膜置换术后口服华法林抗凝的患者提供理论指导的方法。
本研究的参与者为接受人工机械心脏瓣膜置换术且术后随访2年的患者。计算患者的医嘱依从性，并比较不同性别、年龄、地区和教育水平患者在规定时间、规定剂量和定期临床随访方面的依从性分布特征。
采用单因素和多因素逻辑回归分析评估影响依从性的因素。我们的分析表明，心脏瓣膜置换术后患者口服华法林抗凝的依从性受性别、年龄、居住地点和教育程度影响。可通过电话随访相应评估患者的用药习惯。因此，可提供剂量调整建议，显著提高心脏瓣膜置换术后患者口服华法林抗凝的依从性。
心脏瓣膜置换术后患者口服华法林抗凝的依从性受性别、年龄、居住类型、教育水平以及电话临床随访依从性的影响。随访有助于建立良好的医患沟通，这对于及时的用药指导至关重要，从而缩短用药延迟并减少总体治疗时长。
