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Evaluation of patients' knowledge on their vitamin K antagonist treatment
Insights
Patient knowledge of Vitamin K antagonists (VKA) treatment was insufficient for safe and effective use. Educational programs are needed to improve VKA patient understanding and reduce treatment risks.
Area of Science:
- Cardiology
- Pharmacology
- Patient Education
Background:
- Vitamin K antagonists (VKA) are widely prescribed oral anticoagulants in Tunisia.
- Despite standardized monitoring, VKA side effects frequently lead to hospitalizations.
Purpose of the Study:
- To assess patient comprehension of their VKA treatment.
- To identify knowledge gaps in VKA therapy management.
Main Methods:
- A cross-sectional descriptive study was conducted.
- A 14-item questionnaire was administered via semi-directed interviews.
- One hundred patients undergoing VKA treatment were included.
Main Results:
- Only 20% of patients correctly identified the target INR, and 49% understood treatment risks.
- Knowledge of VKA's effect was 70%, but only 22% demonstrated adequate 'know-how' for managing treatment complications.
- Prior VKA information was significantly associated with better knowledge (p = 0.027).
Conclusions:
- Patient knowledge regarding VKA treatment is inadequate for ensuring safety and efficacy.
- A dedicated therapeutic education program is essential.
- Implementing such programs can mitigate the iatrogenic risks associated with VKA therapy.
Introduction:
Vitamin K antagonists (VKA) are currently the most prescribed oral anticoagulant treatment in Tunisia. Despite the standardization of biological monitoring and the better definition of therapeutic objectives, their side effects are a frequent reason for hospitalization.
Aim:
To evaluate patients' knowledge about their VKA treatment.
Methods:
We realized a cross-sectional descriptive study in the Cardiology Department of HabibThameur Hospital from September to October 2016. A questionnaire consisting of 14 items was used in a semi-directed interview in order to assess patients' knowledge on their VKA treatment.
Results:
Our study included one hundred patients. Mean age was 61 ± 12 years and sex ratio of 1.8. Forty-eight per cent were illiterate. The median duration of AVK intake was 5 years. Atrial fibrillation (AF) was the most frequent indication (57%). Eighty percent of patients had more than five correct answers on the eight items of knowledge: VKA's name (96%), tablet description (93%), dose (99%), time (94%), VKA's effect (70%), INR (56%), treatment's risk (49%) and the target INR (20%). Twenty-two percent had more than four correct answers on the 6 items of know-how: what to do in case of haemorrhage (70%), what to do in case of oblivion (45%), interactions precautions to be observed with food (13%), activities advised against (49%) and medical procedures advised against (27%). In multivariate analysis, only prior VKA information was significantly associated with a better knowledge of VKA (p = 0.027).
Conclusion:
Our patients' knowledge on their VKA treatment was insufficient to ensure the safety and efficacy of treatment. The creation of a therapeutic education program on is therefore necessary to reduce the iatrogenic risk of this treatment.