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Does a complex intervention increase patient knowledge about oral anticoagulation? - a cluster-randomised controlled

Verena Maikranz1, Andrea Siebenhofer2,3, Lisa-R Ulrich1

  • 1Institute of General Practice, Goethe-University Frankfurt am Main, Frankfurt, Germany.

BMC Family Practice
|February 8, 2017
PubMed
Summary

A complex intervention significantly improved patient knowledge of oral anticoagulation therapy (OAT) in general practice. This approach, including case management and education, is recommended for enhancing OAT safety and patient understanding.

Keywords:
Case managementGeneral practiceOral anticoagulationPatient educationPatient knowledge

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Area of Science:

  • Gerontology
  • Public Health
  • Clinical Pharmacy

Background:

  • Oral anticoagulation therapy (OAT) presents challenges in general practice, particularly for elderly patients.
  • Inadequate patient knowledge regarding OAT safety is a key factor contributing to complications.
  • The PICANT trial investigated an intervention to address these knowledge gaps.

Purpose of the Study:

  • To evaluate if a complex intervention improves patient knowledge of oral anticoagulation therapy compared to usual care.
  • To assess the effectiveness of practice-based case management, self-management support, and enhanced education for patients and practice teams.

Main Methods:

  • A cluster-randomised controlled trial (PICANT) involving 52 German general practices.
  • 736 patients on long-term OAT were assessed using a 13-item questionnaire at baseline, 12, and 24 months.
  • Linear mixed-effects models analyzed knowledge changes between intervention and control groups.

Main Results:

  • Both groups had similar baseline knowledge (5.6/13).
  • The intervention group showed significantly greater knowledge improvement at 12 months (0.78 vs. 0.04, p=0.0009) and 24 months (0.6 vs. -0.3, p=0.0001) compared to the control group.
  • High retention rates (95.4% at 12 months, 89.3% at 24 months) were observed.

Conclusions:

  • The complex intervention effectively enhanced patient knowledge of oral anticoagulation therapy.
  • This intervention should be implemented in general practice to improve OAT safety and patient outcomes.