Higher OAK (Oral Anticoagulation Knowledge) score at baseline associated with better TTR (Time in Therapeutic Range) in patients taking warfarin

Feldeisen, Delaney; Alexandris-Souphis, Constantina; Haymart, Brian; Gu, Xiaokui; Perry, Lin; Watts, Stephanie W.; Kozlowski, Renee; Kozlowski, J; Froehlich, James B.; Barnes, Geoffrey D.; Kline–Rogers, Eva

doi:10.1007/s11239-022-02718-1

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…A total of 2763 records were retrieved after running the initial search. Overall, 12 studies [9,[19][20][21][22][23][24][25][26][27][28][29] met the inclusion criteria of this systematic review, being selected for synthesis. A manual search was performed, with no identification of any study meeting the eligibility criteria.…”

Section: Resultsmentioning

confidence: 99%

“…Among the selected studies, there were different results regarding the relationship between the variables analyzed. Seven [9,19,[21][22][23][24][25] studies indicated a significant association between the patient level of knowledge on warfarin therapy and TTR, whereas five [20,[26][27][28][29] studies did not indicate statistical significance.…”

Section: Discussionmentioning

confidence: 99%

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Assessment of the relationship between the level of patient knowledge on warfarin therapy and the quality of oral anticoagulation: A systematic review and meta-analysis

et al. 2023

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The present study aimed to investigate the relationship between the level of patient knowledge on warfarin therapy and the quality of oral anticoagulation. This is a systematic review and meta-analysis written on the basis of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline. Searches at MEDLINE, EMBASE, Scopus and LILACS electronic databases were carried out on February 13, 2023, using the descriptors "Patient Medication Knowledge", "Patient Education as Topic", "Health Education", "Patient Education" and Warfarin. The steps of selection, data extraction and quality analysis of articles were performed independently by two reviewers. The analysis was performed considering patient knowledge as a possible modifier of time in therapeutic range (TTR). The meta-analysis included studies that reported the correlation coefficient (Pearson or Spearman) between patient knowledge and TTR. A subgroup analysis was performed according to questionnaires employed to measure patient knowledge. Twelve studies were selected with an overall sample size of 7634 participants and mean age 58.2 (standard deviation (SD)±12,8) years. Eleven (92.0%) cross-sectional studies. The mean TTR was 57.8% (SD±11,3%) and the average level of knowledge was 60.4%. The meta-analysis indicated that patient level of knowledge on warfarin therapy was moderately associated with TTR (rs = 0.435; 95% confidence interval (CI) = 0.163–0.645; I2 = 96%). Subgroup analysis indicated association between knowledge level and TTR in studies employing the OAK test (rs = 0.617; 95% CI = 0.192–0.847; I2 = 97%) and the AKA (rs = 0.269; 95% CI = 0.002 to 0.501; I2 = 94%). However, the subgroup analysis presented no significant difference between them (p = 0.14). The meta-regression showed a non-significant negative effect of age on the correlation (estimate = -0.028, 95% CI = -0.073 to 0.016, p = 0.207). No publication bias was noted (p = 0.881). To our knowledge, this is the first systematic review and meta-analysis gathering evidence about the relationship between the level of patient knowledge on oral anticoagulation with warfarin and TTR. The implementation of structured and patient-centered educational interventions is essential to effectively increase the level of patient knowledge and, thus, to improve the quality and safety of warfarin therapy. Systematic review registration number: PROSPERO CRD42023398030.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Assessment of the relationship between the level of patient knowledge on warfarin therapy and the quality of oral anticoagulation: A systematic review and meta-analysis

et al. 2023

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“…Warfarin is the most commonly prescribed anticoagulant for preventing and treating thrombosis. 1 However, anticoagulation management is notoriously challenging in clinical practice because of the vast number of factors that influence international normalized ratio (INR) control, including its narrow therapeutic window, 2 , 3 many drug and food interactions, 4 miscommunication about dosing between the patient and physician, poor patient knowledge, 5 , 6 adherence, 7 and satisfaction 8 regarding anticoagulation treatment. Knowledge of warfarin, its potential side effects, interacting medicines and foods, and the need for warfarin adherence play a role in attaining the desired therapeutic outcome while preventing adverse reactions.…”

Section: Introductionmentioning

confidence: 99%

Knowledge, Adherence, and Satisfaction With Warfarin Therapy and Associated Factors Among Outpatients at University Teaching Hospital in Ethiopia

Tadesse,

Yadeta,

Chelkeba

et al. 2024

Clin Appl Thromb Hemost

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Anticoagulation management using warfarin is challenging in clinical practice. This study aimed to evaluate the knowledge, adherence, and satisfaction with warfarin therapy and associated factors among outpatients at the Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. An interview-based cross-sectional study was conducted among 350 patients receiving warfarin therapy at cardiac and hematology clinics of TASH. Anticoagulation knowledge assessment (AKA) questionnaires assessed the patients’ warfarin knowledge. Adherence to warfarin was evaluated using the Morisky Green Levine Scale (MGLS), and patient satisfaction with warfarin therapy was assessed using the 17-item anticlot treatment scale (ACTS). Binary logistic regression was used to determine factors associated with the outcome variables, and p < .05 was used as the cut-off point to declare a significant association. The mean AKA score was 59.35 ± 13.04% (10.68 ± 2.34 correct answers), and 82 (23.4%) of participants achieved a passing score. Based on the MGLS, 192 (54.9%) study participants adhered well to warfarin. The mean level of satisfaction was 53.67 ± 8.56, with mean scores of 41.93 ± 7.80 and 11.74 ± 2.43 in the ACTS burden and benefit subscales, respectively. One hundred eighty-four (52.6%) patients were satisfied with warfarin therapy. The absence of hyperthyroidism was significantly associated with poor knowledge of warfarin therapy (adjusted odds ratio [AOR] = 4.28, 95% confidence interval [CI]: 1.01–18.22). Those living with family had a 56% lower chance of poor warfarin adherence (AOR: 0.44; 95% CI: 0.21–0.93) than those living alone. This study shows room for improvement in patient knowledge, adherence, and satisfaction with warfarin therapy.

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Thromboprophylaxis for Coagulopathy Related to COVID-19 in Pediatrics: A Narrative Review

et al. 2023

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In addition to harming the respiratory system, COVID-19 can affect multiple organs. Children may develop a specific complication of COVID-19 called multisystem inflammatory syndrome in children (MIS-C) which could influence the vascular system of children and cause multiple coagulopathies in the body. Information on the use of thromboprophylaxis in this condition was collected via the review of various articles. In general, different factors in immune system responses can trigger the initiation of thrombotic events. Studies have shown that starting anticoagulant prophylaxis, which contributes to decreased thrombotic events, is dependent on the patient's condition and D-dimer levels. However, further studies on pediatric populations are needed to establish the role of anticoagulants in children with this condition.

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Higher OAK (Oral Anticoagulation Knowledge) score at baseline associated with better TTR (Time in Therapeutic Range) in patients taking warfarin

Cited by 3 publications

References 15 publications

Assessment of the relationship between the level of patient knowledge on warfarin therapy and the quality of oral anticoagulation: A systematic review and meta-analysis

Assessment of the relationship between the level of patient knowledge on warfarin therapy and the quality of oral anticoagulation: A systematic review and meta-analysis

Knowledge, Adherence, and Satisfaction With Warfarin Therapy and Associated Factors Among Outpatients at University Teaching Hospital in Ethiopia

Thromboprophylaxis for Coagulopathy Related to COVID-19 in Pediatrics: A Narrative Review

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