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Updated: Aug 31, 2025
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Assessment of Knowledge Regarding Risks and Benefits of the Use of Non-Vitamin K Antagonist Oral Anticoagulants
Jose Raul Valery1, Ahmad Marar2, George Pujalte3
1Division of Community Internal Medicine, Mayo Clinic Florida, Jacksonville, FL, USA.
Background:
Non-vitamin K antagonist oral anticoagulants (NOAC) have replaced vitamin K antagonist (VKA) oral anticoagulants as the first-line treatment option for stroke prevention in high-risk patients with atrial fibrillation. With VKA therapy, disease and treatment-related knowledge is associated with improved adherence and outcomes. There is concern that due to the lack of need for ongoing visits for laboratory monitoring in patients on NOACs, there is less opportunity for education, leading to poor disease- and treatment-related knowledge in this patient group.
Methods:
One hundred ninety-nine (199) patients presenting to 2 primary care clinics on NOAC therapy were surveyed regarding atrial fibrillation and their knowledge regarding NOACs. Chart review was completed to determine patient characteristics and data obtained was compared with survey results to determine the accuracy of the survey responses.
Results:
Patients with a lower degree of NOAC knowledge tended to be older (P < .001), have higher Charlson Comorbidity Index scores (P = .001), use apixaban more often (P = .008), and have been on NOACs for a shorter time period (P = .007).
Conclusions:
There is an opportunity to improve NOAC-related knowledge in patients with atrial fibrillation. When developing educational interventions, patient characteristics associated with poor knowledge should be considered. Based on our results, these are patients who are older, more medically complex, are on apixaban, and have been on NOAC therapy for a shorter duration.
Insights
Patients on non-vitamin K antagonist oral anticoagulants (NOACs) often have lower knowledge about their condition and treatment. Educational interventions should target older, sicker patients on apixaban who are new to NOAC therapy.
Area of Science:
- Cardiology
- Pharmacology
- Primary Care Medicine
Background:
- Non-vitamin K antagonist oral anticoagulants (NOACs) are now first-line for stroke prevention in atrial fibrillation, replacing vitamin K antagonists (VKAs).
- VKA therapy's monitoring facilitated patient education, improving adherence and outcomes.
- Concerns exist that reduced monitoring for NOACs may limit educational opportunities, potentially leading to poorer patient knowledge.
Purpose of the Study:
- To assess the disease and treatment-related knowledge of patients on NOAC therapy for atrial fibrillation.
- To identify patient characteristics associated with lower NOAC knowledge.
Main Methods:
- A survey was administered to 199 patients on NOACs at two primary care clinics.
- Patient characteristics were collected via chart review.
- Survey responses were compared with chart data to assess knowledge accuracy.
Main Results:
- Lower NOAC knowledge was significantly associated with older age (P<.001).
- Higher Charlson Comorbidity Index scores (P=.001) and shorter duration of NOAC therapy (P=.007) were linked to decreased knowledge.
- Patients using apixaban (P=.008) were also found to have less knowledge.
Conclusions:
- There is a clear need to enhance NOAC-related knowledge among atrial fibrillation patients.
- Educational strategies should consider patient factors such as age, medical complexity, specific anticoagulant (apixaban), and treatment duration.
- Targeted interventions can improve understanding and potentially outcomes for patients on NOACs.
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