Pharmacist-Facilitated Interactive E-Learning for Patients Newly Initiated on Warfarin: A Randomised Controlled Study

Abstract

It is not known whether electronic-learning (e-learning) is effective for educating hospital inpatients about complex medications such as warfarin. This prospective randomised controlled study compared pharmacist-facilitated e-learning with standard pharmacist-delivered face-to-face education on patients’ or their unpaid carers’ knowledge of warfarin and satisfaction with warfarin education as well as the time that was spent by pharmacists in delivering warfarin education. Adult English-speaking patients (or their carers) who had been prescribed warfarin were randomised to receive standard pharmacist face-to-face education (control) or an e-learning module on a tablet device facilitated by a pharmacist (intervention). All of the participants received written warfarin information and were presented with the opportunity to ask any questions that they may have had to a pharmacist. Fifty-four participants completed the study (27 per group). The participants who received e-learning had median correct Oral Anticoagulation Knowledge (OAK) test scores of 85% compared to 80% for standard education (p = 0.14). The participants in both groups were satisfied with the information that they received. There was a trend towards pharmacists spending less time on warfarin education for the e-learning group than in the standard education group (25.5 vs. 33 min, respectively, p = 0.05). Education delivered via pharmacist-facilitated e-learning was non-inferior in terms of patient or carer warfarin knowledge compared to standard pharmacist-delivered education.

A SWOT Analysis of Pharmacy Students’ Perspectives on e-Learning Based on a Narrative Review

“…Globally, 39 papers and 1 report were selected: PubMed (n = 33) [ 10 , 13 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ], SciELO (n = 1) [ 52 ], Google Scholar (n = 6) [ 8 , 53 , 54 , 55 , 56 , 57 ], and sites of known international organizations (n = 1) [ 3 ].…”

“…The selected publications were classified as follows: 7 reviews [ 8 , 13 , 23 , 41 , 43 , 52 , 53 ]; 31 original research publications [ 10 , 21 , 22 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 42 , 44 , 45 , 46 , 48 , 49 , 50 , 51 , 55 , 56 , 57 ]; 1 commentary [ 47 ]; 1 case study [ 54 ]; 1 report [ 3 ].…”

Public Perceptions About Home Delivery of Medication Service and Factors Associated with the Utilization of This Service

“…A review of 24 randomized controlled trials assessing multimedia-based medication counseling indicated that this type of service was at least equivalent to other forms of counseling, such as written and face-to-face patient counseling 45 . Furthermore, recent evidence has proposed that individualized video technology consultation with teach-back questions in anticoagulation counseling, such as warfarin which is considered a complex medication, provided similar patient comprehension as standard pharmacists delivered education 46 . It is worth emphasizing that insufficient warfarin education has been shown to be a predictor factor for bleeding complications in patients receiving this inadequate service 46 .…”

“…Furthermore, recent evidence has proposed that individualized video technology consultation with teach-back questions in anticoagulation counseling, such as warfarin which is considered a complex medication, provided similar patient comprehension as standard pharmacists delivered education 46 . It is worth emphasizing that insufficient warfarin education has been shown to be a predictor factor for bleeding complications in patients receiving this inadequate service 46 . Yet, still many previous studies on multimedia patient education intervention on critical chronic medications were inconclusive.…”

“…Previous studies primarily focused on drug counseling and not on the whole picture of patient condition and vulnerability that may affect the health-related outcomes. 46,49,50 It is worth mentioning that the execution of home drug delivery in Jordan is yet traditional. It is implemented at the individual level of the community pharmacies, with limited available resources.…”