Biomedical Research Institute of Málaga (IBIMA Plataforma BIONAND), Málaga, Spain.
Distrito Sanitario Costa del Sol, Servicio Andaluz de Salud, Junta de Andalucía, Málaga, Spain.
Medicine (Baltimore). 2024 Nov 1;103(44):e40258. doi: 10.1097/MD.0000000000040258.
Oral anticoagulation self-control programs have demonstrated efficiency and cost-effectiveness over recent years. This study aimed to evaluate the effectiveness of a training intervention focused on patients with antivitamin K anticoagulants included in a self-care program. For this, we made a quasi-experimental study, pretest and post-test, using a validated questionnaire with 2 measures, before and after an educational intervention about oral anticoagulation focused on patients that will initiate the self-control program in consultation. To check the patient's adherence and coagulation level, we evaluated the Rosendaal time in therapeutic rank, both before and after the intervention. One hundred fifty patients were included since the start of the self-monitoring program in our center in 2016. The mean age was 49 years (standard deviation [SD] = 17.24). The distribution by gender was 76 women and 69 men (52.4%-47.6%). The mean score for the first test was 14.61 (SD = 3.26) and the mean score for the second test was 17.01 (SD = 2.14) (P <.001). We also measured Rosendaal time in therapeutic rank, a parameter that indicates stabilization in international normalized ratio determinations and quality of the anticoagulation management. Values before and after interventions were also statistically significant (67.46 vs 70.53, P <.001). Patients' knowledge improved after the training session, with statistical significance. Despite intentional sampling, the population was homogeneous. Scoring data dispersion in the second test was significantly lower than in the first one. Time on therapeutic rank values was better after the training. We intend to adapt its content to the rest of anticoagulated patients to enhance and improve their follow-up.
近年来，口服抗凝自我管理项目已被证明具有有效性和成本效益。本研究旨在评估一项针对纳入自我护理计划的抗维生素 K 抗凝剂患者的培训干预措施的效果。为此，我们进行了一项准实验研究，在教育干预前后使用经过验证的问卷进行了 2 项测量，该问卷针对将在咨询中启动自我控制计划的患者进行了口服抗凝教育。为了检查患者的依从性和凝血水平，我们评估了在治疗范围内的 Rosendaal 时间，在干预前后均进行了评估。自 2016 年我们中心开始进行自我监测计划以来，共纳入了 150 名患者。平均年龄为 49 岁（标准差[SD]=17.24）。按性别分布，有 76 名女性和 69 名男性（52.4%-47.6%）。第一次测试的平均得分为 14.61（SD=3.26），第二次测试的平均得分为 17.01（SD=2.14）（P<.001）。我们还测量了 Rosendaal 在治疗范围内的时间，这是一个表示国际标准化比值测定稳定和抗凝管理质量的参数。干预前后的值也具有统计学意义（67.46 对 70.53，P<.001）。患者的知识在培训后有所提高，具有统计学意义。尽管进行了有意图的抽样，但人群是同质的。第二次测试的评分数据分散度明显低于第一次测试。治疗范围内的时间值在培训后更好。我们打算将其内容适应于其余的抗凝患者，以增强和改善他们的随访。
