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评估卡塔尔医疗保健专业人员在围手术期华法林管理方面的态度、意识和实践。一项横断面调查。

Assessment of the attitude, awareness and practice of periprocedural warfarin management among health care professional in Qatar. A cross sectional survey.

机构信息

College of Pharmacy, QU Health, Qatar University, Doha, Qatar.

Department of Pharmacy, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.

出版信息

J Thromb Thrombolysis. 2020 Nov;50(4):957-968. doi: 10.1007/s11239-020-02111-w.

Abstract

It is estimated that 10-15% of oral anticoagulant (OAC) patients, would need to hold their OAC for scheduled surgery. Especially for warfarin, this process is complex and requires multi-layer risk assessment and decisions across different specialties. Clinical guidelines deliver broad recommendations in the area of warfarin management before surgery which can lead to different trends and practices among practitioners. To evaluate the current attitude, awareness, and practice among health care providers (HCPs) on warfarin periprocedural management. A multiple-choice questionnaire was developed, containing questions on demographics and professional information and was completed by187 HCPs involved in warfarin periprocedural management. The awareness median (IQR) score was moderate [64.28% (21.43)]. The level of awareness was associated with the practitioner's specialty and degree of education (P = 0.009, 0.011 respectively). Practice leans to overestimate the need for warfarin discontinuation as well as the need for bridging. Participants expressed interest in using genetic tests to guide periprocedural warfarin management [median (IQR) score (out of 10) = 7 (5)]. In conclusion, the survey presented a wide variation in the clinical practice of warfarin periprocedural management. This study highlights that HCPs in Qatar have moderate awareness. We suggest tailoring an educational campaign or courses towards the identified gaps.

摘要

据估计,10-15%的口服抗凝剂 (OAC) 患者需要在预定手术期间停止服用 OAC。特别是对于华法林,这个过程非常复杂,需要跨多个专业进行多层风险评估和决策。临床指南在手术前的华法林管理领域提供了广泛的建议,这可能导致从业者之间的不同趋势和做法。评估医疗保健提供者 (HCP) 对华法林围手术期管理的当前态度、意识和实践。开发了一份多项选择题问卷,其中包含人口统计学和专业信息问题,并由 187 名参与华法林围手术期管理的 HCP 完成。意识中位数 (IQR) 评分中等 [64.28% (21.43)]。意识水平与从业者的专业和教育程度相关(P = 0.009、0.011)。实践倾向于高估华法林停药的必要性以及桥接的必要性。参与者表示有兴趣使用基因测试来指导围手术期华法林管理[中位数 (IQR) 评分(满分 10)= 7 (5)]。总之,调查显示华法林围手术期管理的临床实践存在很大差异。本研究表明,卡塔尔的 HCP 意识中等。我们建议针对已确定的差距开展教育活动或课程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b246/7575475/c50d599f48b6/11239_2020_2111_Fig1_HTML.jpg

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