Patient and physician satisfaction with a telephone-based anticoagulation service

Area of Science:

• Cardiology
• Pharmacology
• Health Services Research

Background:

• Warfarin management requires careful monitoring of the international normalized ratio (INR).
• Patient knowledge and satisfaction are key factors in adherence and therapeutic outcomes.
• Traditional physician-led warfarin management may present challenges in timeliness and patient education.

Purpose of the Study:

• To compare patient satisfaction and knowledge between physician-managed warfarin and a multidisciplinary, telephone-based anticoagulation service (ACS).
• To assess referring physicians' satisfaction with the ACS.

Main Methods:

• A survey was conducted with 300 warfarin patients across eight health centers, randomized to either ACS access or control.
• Patients were assessed on INR monitoring timeliness, warfarin safety perception, overall satisfaction, and INR knowledge.
• Physicians referring to the ACS were surveyed on time savings, satisfaction, and willingness to recommend.

Main Results:

• Patients with ACS access reported higher satisfaction with blood test result timeliness (P=.02) and felt safer on warfarin (P=.04).
• Knowledge of safe INR values significantly increased in the ACS group (45% vs 15%, P=.001).
• Physicians reported time savings (4 minutes physician, 13 minutes staff per INR) and high satisfaction, with all recommending the ACS.

Conclusions:

• A telephone-based ACS significantly enhances patient satisfaction and knowledge of antithrombotic therapy.
• Primary care physicians endorse the ACS, recognizing its efficiency and benefits.
• The findings support the integration of telephone-based ACS into routine warfarin management.