Alarming lack of knowledge about antithrombotic therapy among patients with atrial fibrillation

Abstract

Large population campaigns have been conducted in Brazil to improve knowledge about the signs and symptoms of stroke and the importance of time to care. Objective: Parallel to these important actions, we aimed to evaluate the lay knowledge of patients with atrial fibrillation, a well-recognized etiology of stroke, adequate treatment and management of which can prevent up to 30% of cerebrovascular events. Methods: We questioned 143 patients with atrial fibrillation about the risks associated with the disease. Results: Ninety-one percent were on anticoagulation treatment. Of the total, 63.6% reported having been informed about the risks and benefits of anticoagulants but only 46.9% were able to correctly mention one of these risks. Ischemic stroke was identified as a risk by only 25.9% and hemorrhagic stroke was not mentioned. A CHADS2 ≥ 2 was scored by 84.0% of the patients. Conclusions: Our study showed an alarming knowledge gap in patients with atrial fibrillation. Difficulty in adherence to treatment resulting from the failure of this communication is possibly one of the factors responsible for the high incidence and recurrence of stroke, and should not go unnoticed.

The information needs of patients with atrial fibrillation: A scoping review

“…Seventeen studies reported patients’ lack of and need for understanding AF (Clarkesmith, Lip, et al 2017; Clarkesmith, Pattison, et al, 2017; Desteghe et al, 2016; Fitzgerald et al, 2020; Frankel et al, 2015; Konieczynska et al, 2018; LaRosa et al,2019; Lee et al, 2013; Leitao et al, 2018; Lindberg et al, 2017; McCabe et al, 2020; McCabe et al, 2015; McCabe et al, 2011; Redman et al, 2017; Salmasi et al, 2019; Toscos et al, 2020; Thrysoee et al, 2018; Zweiker et al, 2017). In particular, patients with AF needed ‘easy‐to‐understand information’ about the disease, ‘screening and diagnosis’, and ‘trajectory of AF and its associated risks’.…”

“…Many of the included studies ( n = 9) have described the limited knowledge among patients about the disease progression of AF and its associated risk for stroke and heart failure (Bull, 2015; Desteghe et al, 2016; Fitzgerald et al, 2020; Frankel et al, 2015; Konieczynska et al, 2018; LaRosa et al, 2019; Lee et al, 2013; Leitao et al, 2018; Zweiker et al, 2017). Up to 60% of the patients were found to be unaware of the risk of stroke associated with AF across the studies (Desteghe et al, 2016; Konieczynska et al, 2018; Lee et al, 2013; Leitao et al, 2018; Zweiker et al, 2017). In qualitative interviews, patients with AF expressed that they felt uninformed or in some cases misinformed about what to expect with the diagnosis and the possible trajectories of AF (McCabe et al, 2020; McCabe et al, 2011).…”

“…The majority of the included studies ( n = 17) discerned the need for information about the treatment of AF (Amara et al, 2016; Bull, 2015; Desteghe et al, 2016; Fitzgerald et al, 2020; Frankel et al, 2015; Kaufman et al, 2018; Konieczynska et al, 2018; Lee et al, 2013; Leitao et al, 2018; Lindberg et al, 2017; McCabe et al, 2020; Polovina et al, 2017; Salmasi et al, 2019; Smet et al, 2018; Taylor et al, 2018; Toscos et al, 2020; Thrysoee et al, 2018). Three aspects have been highlighted, that is, ‘role of anticoagulation’, ‘existing or novel therapeutic options’ and ‘monitoring effectiveness of treatment’.…”

Communication gap between health professionals and patients on anticoagulant therapy in the WhatsApp era

“…In a modern world that sends more than 55 billion WhatsApp messages per day, the scenario depicted by the Leitão et al 4 study is unacceptable. As with every medical treatment, the correct and safe use of anticoagulant therapy among our patients is paramount and tells us that we urgently need to improve the communication of information to our patients.…”

“…In this issue of Arquivos de Neuro-Psiquiatria, Leitão et al 4 report alarming data about the lack of knowledge of antithrombotic therapy among patients with atrial fibrillation. The authors initially interviewed 150 patients and included 131 of those on anticoagulation therapy in this study.…”