Assessment of Patients' Awareness of Anticoagulant Use in Atrial Fibrillation: A Cross-Sectional Survey

Atrial fibrillation (AF) increases thromboembolic risk, and oral anticoagulants (OACs) substantially reduce this risk; however, their safe and effective use requires adequate patient knowledge. We aimed to assess AF- and OAC-related awareness among Turkish patients and to identify predictors of knowledge.

This single-center, cross-sectional survey was conducted between July 1, 2024 and January 1, 2025, and included consecutive adults with non-valvular AF receiving warfarin or direct OACs for at least three months. A structured questionnaire collected data on demographic characteristics, comorbidities, medication use, adherence, and knowledge across six domains: arrhythmia name, treatment indication, dosing schedule, side effects, drug and food interactions, and consequences of dose modification. A composite knowledge score (range, 0���6) was calculated. Multivariable linear regression was used to evaluate predictors of knowledge, including age, sex, and education level. Ethics approval was obtained, and all participants provided written informed consent.

A total of 261 patients were included (median age, 67 years; 50.2% women). Hypertension and diabetes mellitus were present in 64.8% and 32.2% of patients, respectively. Direct oral anticoagulants (DOACs) accounted for 72.4% of prescriptions, whereas 27.6% of patients received warfarin. Although 36% of participants had AF for more than six years, only 16.5% could correctly name their arrhythmia. While 92% knew they were taking an anticoagulant, 24% misunderstood its indication. Knowledge of side effects was limited, with 68% reporting no awareness. Awareness of interactions was poor: 88% reported no knowledge of drug���drug interactions, and 71% were unaware of food interactions. Most patients knew their dosing schedule (92.3%) and reported that they would not double a missed dose (99.6%). Self-reported adherence was high (94% 'always' and 4% 'often'), and taking medication with meals was associated with better adherence (���� = 17.0, P < 0.001). The mean knowledge score was 2.8 +- 1.3 (Cronbach's �� = 0.50). Higher educational attainment and female sex were associated with greater knowledge, whereas age was inversely associated with knowledge.

Despite high self-reported adherence, substantial knowledge gaps persist among patients receiving anticoagulation for AF, particularly regarding side effects and drug or food interactions. Targeted, health-literacy-sensitive educational strategies may improve medication safety and clinical outcomes in patients receiving anticoagulation for AF.