Shilbayeh Sireen Abdul Rahim
Department of Pharmaceutical Practice, College of Pharmacy, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia.
J Pharm Bioallied Sci. 2020 Oct-Dec;12(4):413-422. doi: 10.4103/jpbs.JPBS_188_20. Epub 2020 Oct 8.
Internationally, various warfarin education strategies have been described in the medical literature and delivered by a variety of health-care providers. However, none of these were tested in a Saudi setting.
The aim of this study was to assess the impact of pharmacist interventions via an educational video on improving patient knowledge of and satisfaction with warfarin therapy and the international normalized ratio (INR).
This study adopted a prospective pre- and posttest design and enrolled 91 patients from an anticoagulant clinic at King Khaled University Hospital in Riyadh, Saudi Arabia, between September 2017 and February 2018.
All patients completed the Anticoagulation Knowledge Assessment (AKA) and Anti-Clot Treatment Satisfaction (ACTS) scales. Subsequently, the patients watched a 10-min educational video containing basic information regarding warfarin and were given relevant informative booklets. The patients were reassessed after a mean follow-up period of approximately 52 days.
In total, 85 patients completed the study. The impact of the intervention on patient knowledge was highly significant (mean difference = 17.7%, 95% confidence interval (CI) = 21.75-13.58, < 0.000). In addition, the patients showed significant increases in their ACTS benefits subscale scores (mean difference = 0.73, 95% CI = 1.22-0.24, = 0.004). Despite being long-term warfarin users, the patients' INRs had a greater tendency to be within the target range after the intervention (56.63% ± 35% vs. 64.72% ± 35% of the time; mean difference, 8.1 percentage points; effect size = 0.23). However, there was no significant effect on patients' perceptions of the warfarin burden.
This study provided evidence that a pharmacist-led audiovisual intervention via an educational video coupled with an informational booklet effectively improved patients' knowledge retention and satisfaction with warfarin therapy benefits. Longer studies are needed to determine the impact of this intervention on patients' perceptions of warfarin burdens and their INRs.
在国际上,医学文献中描述了各种华法林教育策略,并由多种医疗保健提供者实施。然而,这些策略均未在沙特的环境中进行过测试。
本研究的目的是评估通过教育视频进行的药剂师干预对提高患者对华法林治疗及国际标准化比值(INR)的知识水平和满意度的影响。
本研究采用前瞻性前后测设计,于2017年9月至2018年2月期间,招募了沙特阿拉伯利雅得国王哈立德大学医院抗凝门诊的91名患者。
所有患者均完成抗凝知识评估(AKA)和抗凝血治疗满意度(ACTS)量表。随后,患者观看了一段包含华法林基本信息的10分钟教育视频,并获得了相关信息手册。在平均约52天的随访期后对患者进行重新评估。
共有85名患者完成了研究。干预对患者知识水平的影响非常显著(平均差异=17.7%,95%置信区间(CI)=21.75 - 13.58,P<0.000)。此外,患者的ACTS益处子量表得分显著提高(平均差异=0.73,95%CI = 1.22 - 0.24,P = 0.004)。尽管患者长期使用华法林,但干预后患者的INR更倾向于处于目标范围内(分别为56.63%±35%和64.72%±35%的时间;平均差异,8.1个百分点;效应大小=0.23)。然而,对患者对华法林负担的认知没有显著影响。
本研究提供了证据,表明通过教育视频和信息手册由药剂师主导的视听干预有效地提高了患者对华法林治疗益处的知识保留率和满意度。需要进行更长时间的研究来确定这种干预对患者对华法林负担的认知及其INR的影响。