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KIDCLOT: the importance of validated educational intervention for optimal long term warfarin management in children

M E Bauman1, K Black, S Kuhle

  • 1Stollery Children's Hospital, Edmonton, AB, Canada. mary.bauman@capitalhealth.ca

Thrombosis Research
|September 13, 2008
PubMed

Insights

A new child-focused warfarin education program, KIDCLOT-POC, significantly improved knowledge in children and caregivers. This led to high time in therapeutic range (TTR), indicating safe and effective anticoagulation management in pediatric patients.

Area of Science:

  • Pediatric Hematology
  • Pharmacology
  • Medical Education

Background:

  • Thrombosis is a significant complication in children surviving critical illnesses, posing risks of mortality and morbidity.
  • Warfarin therapy in children is challenging due to narrow therapeutic index and variable factors affecting drug metabolism and response.
  • Frequent International Normalized Ratio (INR) monitoring is essential for safe warfarin use in pediatric patients.

Purpose of the Study:

  • To evaluate the effectiveness of a novel child-focused educational program (KIDCLOT-POC) for warfarin therapy and point-of-care INR monitoring.
  • To assess the impact of the educational program on knowledge acquisition and retention in pediatric patients and their caregivers.
  • To determine the effect of the program on achieving and maintaining the time in therapeutic range (TTR) for warfarin therapy.

Main Methods:

  • The KIDCLOT-POC program was implemented by the Pediatric Anticoagulation program at Stollery Children's Hospital.
  • Twenty-eight children and their caregivers participated, undergoing theoretical and practical assessments of warfarin management knowledge.
  • Knowledge was evaluated using pre, post, and retention questionnaire scores, alongside practical demonstrations.

Main Results:

  • Caregiver knowledge scores significantly improved from pre- (median 50) to post- (median 93) and retention (median 96) assessments (p<0.0001).
  • Pediatric participants (age ≥6 years) demonstrated high post- (median 90) and retention (median 92) knowledge scores.
  • The overall time in therapeutic range (TTR) for all children in the study was 81.7% (SD 13.1).

Conclusions:

  • The KIDCLOT-POC program effectively enhanced knowledge development and retention regarding warfarin management in children and caregivers.
  • The program is associated with high TTR, suggesting improved adherence, safety, and efficacy of warfarin therapy.
  • Implementation of KIDCLOT-POC shows promise for optimizing anticoagulation management in pediatric populations without adverse events.
Abstract

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