Patient Knowledge about Oral Anticoagulation Therapy Assessed during an Intermediate Medication Review in Swiss Community Pharmacies

Abstract

Background: Therapy with oral anticoagulation (OAC) can be challenging, especially in high risk groups such as chronic patients. Gaps in patient knowledge about OAC are linked to reduced effectiveness and safety of treatment. The objectives of this study were i) to assess OAC knowledge gathered during an intermediate medication review (MR) in patients taking vitamin K antagonists (VKA) or non-vitamin K antagonist oral anticoagulants (NOAC); ii) to assess OAC knowledge two weeks after the MR, and iii) to evaluate patient satisfaction with the MR service in community pharmacies. Methods: Chronic OAC patients were invited for a regular MR service in Swiss community pharmacies, the so-called “Polymedication-Check” (PMC). OAC knowledge was assessed with seven newly generated items asked face-to-face during a PMC and by telephone two weeks later. Knowledge gaps, pharmacists’ spontaneous interventions, and patient satisfaction were documented by observing pharmacy students. Treatment groups were compared. Results: Of all patients (n = 81), the number of patients with one or more knowledge gaps decreased from 66% to 31.3% after PMC (p < 0.001). NOAC patients (n = 31) had more knowledge gaps than VKA patients (n = 50; p < 0.05). Most patients (98.6%) were satisfied with the counselling provided by the pharmacists. Conclusion: The majority of chronic OAC patients shows knowledge gaps. Although spontaneous, the provision of tailored education during a PMC increased patient OAC knowledge.

An Analysis of Perceived and Actual Anticoagulant Knowledge among Independent Pharmacy Patients

“…Incomplete knowledge of anticoagulant therapies commonly occurs among patients in various settings. 6 , 9 - 10 , 12 - 14 Difficulties identifying notable side effects and drug interactions with anticoagulants are apparent. 15 - 17 , 19 Moreover, patients have demonstrated minimal understanding of their clinical conditions that lead to anticoagulant use.…”

“… 3 – 5 Opportunities therefore remain to increase knowledge of anticoagulants among patients within different healthcare systems such as pharmacies. 6 It is beneficial for patients in pharmacies and other settings to have a better grasp of the details about anticoagulant regimens that often consist of side effects that may be experienced. 7 – 8 It is also worthwhile for patients to be able to recognize anticoagulant-related concerns that warrant notifying healthcare personnel.…”

“…9 Increased alertness to possible signs of adverse therapy events can foster greater adherence and empower patients to use their anticoagulant regimens with greater clarity and confidence. 6 …”

“…14 – 15 Furthermore, recall of anticoagulant information for a brief period may overestimate patients’ comfort level with their prescribed regimens. 6 , 16 In addition, diminished health literacy has the potential to affect patients’ understanding of their anticoagulation care. 12 , 15 Equally as important, disparities exist among patient comprehension levels of anticoagulants by racial demographics.…”

Assessment of adherence, treatment satisfaction and knowledge of direct oral anticoagulants in atrial fibrillation patients

“…17 Another study described that DOAC patients had more knowledge gaps than VKA patients. 31 For this important task, the significant role of the clinical pharmacist has been demonstrated by some studies. 4,32 when simple written information is combined with verbal counselling such as cue cards, audio-visual resources depicting real-life scenarios, and/or socio-culturally appropriate images.…”