This comprehensive review highlights that education about warfarin in older patients is currently suboptimal and may in part contribute to poor therapeutic outcomes. This review article also acknowledges the need to identify, target, and develop educational strategies and resources to further improve older patients' knowledge about their warfarin therapy.
ObjectiveTo explore healthcare professionals' views about the benefits and
challenges of using information technology (IT) resources for educating
patients about their warfarin therapy.MethodsA cross-sectional survey of both community and hospital-based healthcare
professionals (e.g., doctors, pharmacists and nurses) involved using a
purpose-designed questionnaire. The questionnaires were distributed using a
multi-modal approach to maximise response rates.ResultsOf the total 300 questionnaires distributed, 109 completed surveys were
received (43.3% response rate). Over half (53.2%) of the healthcare
participants were aged between 40-59 years, the majority (59.5%) of whom
were female. Fifty nine (54.1%) participants reported having had no access
to warfarin-specific IT-based patient education resources, and a further 19
(38.0%) of the participants who had IT-access reported that they never used
such resources. According to the healthcare participants, the main
challenges associated with educating their patients about warfarin therapy
included: patient-related factors, such as older age, language barriers,
cognitive impairments and/or ethnic backgrounds or healthcare professional
factors, such as time constraints. The healthcare professionals reported
that there were several aspects about warfarin therapy which they found
difficult to educate their patients about which is why they identified
computers and interactive touch screen kiosks as preferred IT devices to
deliver warfarin education resources in general practices, hospital-based
clinics and community pharmacies. At the same time, the healthcare
professionals also identified a number of facilitators (e.g., to reinforce
warfarin education, to offer reliable and easily comprehensible information)
and barriers (e.g., time and costs of using IT resources, difficulty in
operating the resources) that could impact on the effective implementation
of these devices in educating patients about their warfarin therapy.ConclusionsThe findings of the study suggest that there is a need for improving
healthcare professionals' use of, and access to IT-based warfarin
education resources for patients. The study findings also suggest addressing
the concerns raised by the healthcare professionals when implementing such
IT resources successfully to help educate patients about their warfarin
therapy.
Background: Effective management of warfarin therapy is often challenged by its complex pharmacology and preventable adverse events. One strategy to ensure safe warfarin use is provision of comprehensive warfarin education to patients. Aim: To review the provision of warfarin education to hospital patients prescribed warfarin and to describe patient characteristics that may impact on warfarin education. Method: A prospective study was undertaken at 2 large Australian metropolitan hospitals. Provision of warfarin education was identified by auditing the medication charts and clinical notes of hospitalised older patients (≥ 65 years). Patients were also interviewed to confirm whether they recalled receiving warfarin education during their hospital stay. Results: Data were collected for 96 patients with a mean age of 74 (SD 13) years. Most patients (78%) were admitted to medical wards, were taking warfarin for atrial fibrillation (56%), and had started warfarin prior to admission (54%). 36% of patients had provision of warfarin education documented in medication charts and clinical notes, and in most cases warfarin education was provided by a pharmacist. Of the 68 patients available for interview, only 47% recalled receiving warfarin education; in the majority of cases they cited pharmacists as providers of the education. Conclusion: There is a need to improve documentation and provision of warfarin education to hospital patients.
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