Knowledge and Adherence to Oral Anticoagulant Therapy among Patients with Mechanical Heart Valve Prosthesis

Sharaf, Amany Youssef; Ibrahim, Alyaa Farouk Abd El-Fattah; Elhamami, Moustafa

doi:10.9790/1959-0603021929

Cited by 3 publications

(5 citation statements)

References 22 publications

(35 reference statements)

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“…These scores were higher compared with those reported by Desteghe et al and in the EHRA study [15,18]. Previous studies showed moderate or poor knowledge concerning the treatment among patients with artificial valve prostheses [23,24,26]. Improved knowledge has been associated with improved compliance and control [23].…”

Section: Discussionmentioning

confidence: 67%

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Low Level of Knowledge of Atrial Fibrillation and Anticoagulant Treatment among Patients with Atrial Fibrillation Scheduled for Cardiac Surgery

Lipska¹,

Undas²,

Heidbüchel³

et al. 2020

JICOA

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Objective: We investigated the knowledge about atrial fibrillation (AF) and oral anticoagulants (OACs) in AF patients scheduled for cardiac surgery compared with nonsurgical AF patients. Methods: We recruited 144 consecutive patients with documented AF scheduled for cardiac surgery on admission (aged 68.9±8.4, male 60.4 %). The control group represented 200 age- and sex-matched AF patients without indications for surgery. Using the validated Jessa AF Knowledge Questionnaire (JAKQ), we tested their knowledge of AF and the use of OAC. Results: The mean score on the JAKQ was 47±20 % in the surgery group and 59±18 % in the control group (p<0.001), without any questions in which the former group scored better. A higher level of knowledge was observed in patients taking vitamin K antagonists (VKA) in the past, and individuals free of heart failure, previous stroke, or peripheral artery disease. Patients had poor knowledge of the safety issues, including 27.5% of surgical patients who knew about possible painkillers use during anticoagulation compared with 43.8% in the control group (p=0.002). Patients scheduled for valvular surgery (n=88, 61.5%) scored better compared with those (n=26, 18.2%) for coronary artery bypass graft (CABG) surgery (49±19% vs. 35±18 %, p=0.002 respectively). Conclusion: The level of knowledge about AF and its treatment, including the safety issues, is poor among AF patients admitted for cardiac surgery. More educational efforts should be taken in this vulnerable patient subset.

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Section: Discussionmentioning

confidence: 67%

“…Given the fact that patients with artificial valve implantation require lifelong OAC to prevent thromboembolic events, knowledge gaps among VKA users reported by us are of particular importance [24,25]. Reassuringly, we found that most of the surgical patients on VKA were aware of the mandatory monthly INR monitoring.…”

Section: Discussionmentioning

confidence: 78%

Low Level of Knowledge of Atrial Fibrillation and Anticoagulant Treatment among Patients with Atrial Fibrillation Scheduled for Cardiac Surgery

Lipska¹,

Undas²,

Heidbüchel³

et al. 2020

JICOA

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“…In developing countries, the situation tends to be worse. Previous work from our institution showed that only 42.7% of patients had satisfactory adherence levels to anticoagulation after mechanical valve implantation [Sharaf 2017]. Al Halees reported that only 25% of patients attending their anticoagulation clinics in Saudi Arabia fell within the target INR range, citing regions where even access to warfarin was a problem [Al Halees 2007].…”

Section: Discussionmentioning

confidence: 95%

“…Probably due to a combination of lower levels of education and compliance to anticoagulation [Sharaf 2017], the reported incidence of such a fatal complication is as high as 6.1% per patient-year in developing countries compared with a much lower incidence of 0.3-1.3% per patient-year in the Western world [Nishimura 2014].…”

Section: Introductionmentioning

confidence: 99%

Early Outcomes of Emergency Surgery for Left-Sided Mechanical Valve Thrombosis

Saleh¹,

Azzam²,

Swailum³

et al. 2021

HSF

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Background: Valve thrombosis is a potentially lethal complication of mechanical cardiac valves. We examined the clinical characteristics as well as the early outcomes of patients undergoing emergency surgery for left-sided mechanical valve thrombosis. Methods: Between January 2012 and May 2020, 104 consecutive patients were offered an emergency redo surgery for acute mechanical valve thrombosis. Ninety-seven of these patients were included in the current study. Results: The mean age was 34.2 ± 10.3 years. Most of the patients were females (61 patients), and 27 patients (27.8%) were pregnant. The mitral valve was the site of thrombosis in 81 patients. Inadequate anticoagulation was found in 60.8% of patients. The overall early mortality was 32.9% (32 patients) with an operative mortality of 25.7%. Outcomes in the pregnant subgroup tended to be worst with a maternal mortality in the range of 37%, and with fetal and neonatal survival as low as 33.3%. Conclusion: The overall mortality in cases of mechanical valve thrombosis warranting surgery remains high. Since inadequate anticoagulation seems to be one of the major precipitating factors, the current study highlights the need for improvements in anticoagulation practices. The use of tissue valves should also be contemplated more seriously in some younger patients, especially females expressing the desire for future pregnancies.

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“…A não adesão aos medicamentos aumenta as morbidades, as mortalidades e os custos dos cuidados com a saúde. Apenas 50% dos pacientes com doenças crônicas aderem aos seus medicamentos nos países desenvolvidos, tal como relatado pela OMS 8 .…”

Section: Introductionunclassified

Knowledge and Adherence to Warfarin’s Treatment Regimen Among Patients in Alshaab and Ahmed Gasim Hospitals, Sudan, 2018

Ahmed

2022

Braz. Jour. Global Health

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OBEJCTIVE: Warfarin is an oral anticoagulant drug that needs continuous clinical and laboratory monitoring due to its narrow therapeutic index and life-threatening complications. This study aims to assess knowledge and adherence of patients to their warfarin treatment regimen and to identify barriers that prevent patients to take their warfarin therapy regularly. METHODS: In this cross-sectional study, a systematic random sample of 307 patients was selected from Alshaab teaching hospital heart section and Ahmed Gasim Hospital. Data was collected by anonymous interview-based questionnaires. RESULTS: Male patients (52.5%) exceeded females (44.8%), the mean age was 48.79. About 57.98% of the studied patients had moderate overall knowledge score, and more than half of them had good adherence levels (62.2%). The study shows that: Forgetting (43.7%) was the main barrier preventing the patients from taking their medication, followed by drug unavailability (36.8%) and high cost (19.5%). There are statistically significant differences between patient’s age/education and their level of knowledge (p=0.008/p=0.011). The correlations between patients’ adherence to warfarin oral anticoagulant and their level of knowledge is statistically insignificant (r=0.647, p=0.739). There are significant association between patients' level of adherence and the time from which the patient starts to take warfarin (p-value= .034). CONCLUSION: The majority of the studied patients had moderate overall knowledge score about Warfarin oral anticoagulant, and more than half of them had good adherence levels. “Forgetting” was the main barrier preventing the patients from taking their medication. DESCRIPTORS: Warfarin, Knowledge, Adherence, Barriers.

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Knowledge and Adherence to Oral Anticoagulant Therapy among Patients with Mechanical Heart Valve Prosthesis

Cited by 3 publications

References 22 publications

Low Level of Knowledge of Atrial Fibrillation and Anticoagulant Treatment among Patients with Atrial Fibrillation Scheduled for Cardiac Surgery

Low Level of Knowledge of Atrial Fibrillation and Anticoagulant Treatment among Patients with Atrial Fibrillation Scheduled for Cardiac Surgery

Early Outcomes of Emergency Surgery for Left-Sided Mechanical Valve Thrombosis

Knowledge and Adherence to Warfarin’s Treatment Regimen Among Patients in Alshaab and Ahmed Gasim Hospitals, Sudan, 2018

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