Polish regional differences in patient knowledge on atrial fibrillation and its management as well as in patterns of oral anticoagulant prescription

Janion−Sadowska, Agnieszka; Sadowski, Marcin; Konieczyńska, Małgorzata; Skonieczny, Grzegorz; Metzgier-Gumiela, Agnieszka; Chrapek, Magdalena; Sobieraj, Ewa; Bryk, Agata Hanna; Dębski, Maciej; Podolec, Piotr; Małecka, Barbara; Desteghe, Lien; Heidbüchel, Hein; Undas, Anetta

doi:10.5603/kp.a2019.0036

Cited by 15 publications

(30 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Furthermore, authors found that knowledge of AF symptoms and its progressive course was significantly worse in patients from a small volume district hospital compared with peers from a tertiary cardiology center. 28 Essential and relevant information may be provided to patients with AF and a pacemaker at regular device follow -up visits.…”

Section: Figure 3 Association Of Baseline Factors With Permanent Atrimentioning

confidence: 99%

Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Dębski¹,

Ulman²,

Ząbek³

et al. 2019

Kardiol Pol

Self Cite

View full text Add to dashboard Cite

BACKGROUND Atrial fibrillation (AF) is thought to be a progressive arrhythmia. The impact of sex and position of right ventricular lead is not well recognized. Whilst nonparoxysmal AF compared with paroxysmal AF has been associated with increased mortality in the general population, its prognostic significance in patients with a dual -chamber (DDD) pacemaker is less clear. AIMS The aim of the study was to determine the incidence of permanent AF in patients with a DDD pacemaker, analyze the effect of selected baseline characteristics on permanent AF development, and examine the impact of permanent AF on patient survival. METHODS A retrospective cohort study included 3932 consecutive patients who underwent DDD pacing system implantation between 1984 and 2014. Follow -up was completed in August 2016. We included 3771 patients (96%) with post -operative follow -up and known vital status. Occurrence of permanent AF and all -cause mortality were the study endpoints. RESULTS During mean follow -up of 6.5 years, permanent AF occurred in 717 patients (19%). Sex (hazard ratio [HR], 1.316; 95% CI, 1.134-1.528, for men), age at implant (HR, 1.041; 95% CI, 1.033-1.049, 1-year increase), history of AF (HR, 3.521; 95% CI, 3.002-4.128) were independently associated with permanent AF development, whereas position of right ventricular lead (apical versus nonapical) and primary pacing indication (atrioventricular block versus sick sinus syndrome) were not related to permanent AF. Permanent AF was a significant risk factor for increased mortality (age-and sex -adjusted HR, 1.475; 95% CI, 1.294-1.682). CONCLUSIONS Permanent AF occurrence was independently predicted by advanced age at implant, male sex, and preexisting AF and associated with worse survival.

show abstract

Section: Figure 3 Association Of Baseline Factors With Permanent Atrimentioning

confidence: 99%

Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Dębski¹,

Ulman²,

Ząbek³

et al. 2019

Kardiol Pol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Emren et al reported similar findings. The relationship between therapy duration and minor bleeding was also shown in a study by Janion‐Sadowska et al, who investigated the rates of minor bleeding in three cardiology centres. The lowest rate of minor bleeding was registered at centre II, where the time of using anticoagulant therapy was the shortest .…”

Section: Discussionmentioning

confidence: 56%

“…The relationship between therapy duration and minor bleeding was also shown in a study by Janion‐Sadowska et al, who investigated the rates of minor bleeding in three cardiology centres. The lowest rate of minor bleeding was registered at centre II, where the time of using anticoagulant therapy was the shortest . It is well known that patient education is important, with a routine follow‐up recommended to assess adherence and discuss barriers to treatment with patients, both in patients on a NOAC or VKA.…”

Section: Discussionmentioning

confidence: 56%

“…Patients with documented AF on oral anticoagulation (OAC) were recruited from December 2017 to June 2018. The methodology was described in detail previously . All study participants were older than 18 years and were able to provide informed consent.…”

Section: Methodsmentioning

confidence: 99%

“…One of the questionnaires testing the knowledge of patients with AF is the Jessa AF Knowledge Questionnaire (JAKQ), designed and validated in 2016 . This questionnaire used in the Polish population with AF reported by Konieczyńska et al and Janion‐Sadowska et al documented that patients with AF have insufficient knowledge. In 2017, Konieczyńska et al reported minor bleeding in 41.3% of anticoagulated patients with AF.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Minor bleeding affects the level of knowledge in patients with atrial fibrillation on oral anticoagulant therapy

et al. 2020

Self Cite

View full text Add to dashboard Cite

Despite advances in treatment, atrial fibrillation (AF) remains the cause of about 15% to 20% of all strokes and 36% of strokes in individuals older than 80 years, which results in high morbidity and mortality worldwide. 1,2 Large randomised trials demonstrated that anticoagulant therapy in AF patients reduces the relative risk of stroke approximately by 65%, 3 but it also increases the risk of bleeding. Major bleeding in AF patients was reported in the range 2%-3.6% of subjects treated with non-vitamin K antagonist oral anticoagulants (NOACs) and about 3% in those on warfarin in seminal NOAC trials. [4][5][6] The various studies showed that minor bleeding is also a frequent adverse event both with VKA and NOAC (depending on the definition of minor bleeding). 7-9 Abstract Background: Anticoagulant therapy in patients with atrial fibrillation (AF) increases the risk of minor bleeding, which is mostly accepted by patients. We aimed to assess whether continuation of anticoagulation despite minor bleeding is associated with a higher level of knowledge on AF and anticoagulation. Methods and results:In 1525 patients with AF on oral anticoagulation who completed the Jessa AF Knowledge Questionnaire (JAKQ) (median age: 72 years [range, 65-79 years]; men: 54.6%), persistent self-reported minor bleeding was recorded.Minor bleeding was observed in 567 patients (37.2%) including 224 patients (39.5%) on vitamin K antagonists (VKAs) and 343 (60.5%) on non-vitamin K antagonist oral anticoagulants (NOACs). The risk of minor bleeding was lower among patients on NOACs than on VKAs (33.5% vs 44.6%; P < .0001). Multiple logistic regression showed that minor bleeding was associated with the use of NOACs (odds ratio [OR] 0.75; 95% CI 0.59-0.97), female gender (OR 2.19; 95% CI, 1.74-2.75; P < .0001), history of major bleeding (OR 2.85; 95% CI, 1.96-4.14; P < .0001), time since AF diagnosis (OR 1.04; 95% CI, 1.01-1.06; P < .0001), concomitant vascular disease (OR 1.43; 95% CI, 1.10-1.87; P = .0008) and diabetes mellitus (OR 1.3; 95% CI, 1.02-1.65, P = .03).Patients with minor bleeding, compared with the remaining subjects scored higher on the JAKQ (median, 62.5% vs 56.2%, respectively, P < .0001). The former group knew more about the purpose of anticoagulant therapy (71.8% vs 65.7%, P = .01) and bleeding as its key side effect (66.1% vs 52.7%, P < .0001), and were better informed on the safest painkillers to use in combination with anticoagulation (48% vs 35%, P < .0001). Conclusion:This study suggests that AF patients who accept persistent minor bleeding have better knowledge on the disease and anticoagulation therapy compared with those free of these side effects.

show abstract

Clinical implication of the patient's disease awareness and adherence to medications in patients undergoing atrial fibrillation ablation

Sawada,

Otsuka,

Nagashima

et al. 2023

Journal of Arrhythmia

View full text Add to dashboard Cite

BackgroundThe effects of the patient's disease awareness on the management of postablation of atrial fibrillation (AF) are unknown.MethodsOne hundred thirty‐three AF patients undergoing an initial ablation were given a disease awareness questionnaire with a score of 16 points (8 points about AF in general and 8 points about oral anticoagulants) for the Jessa Atrial Fibrillation Knowledge Questionnaire (JAKQ) before and 1‐year‐after ablation. We divided them into the poor disease awareness group and good disease awareness group according to the median value (75%) of the total JAKQ score about AF in general, and compared the baseline patient characteristics and the 1‐year changes in the JAKQ score, medication adherence, blood pressure, laboratory data, echocardiographic parameters, and AF/atrial tachycardia (AT) recurrence rate between the two groups.ResultsForty‐two (31.6%) patients were classified as having poor disease awareness (<75% of the total JAKQ score), which was closely associated with poor medication adherence, hypertension, diabetes, dyslipidemia, and greater left atrial volume (LAV). These trends in the poor disease awareness group remained unchanged 1 year after the ablation. During the 25.3‐month follow‐up, the AF/AT recurrence rate was significantly higher in the poor disease awareness than the good disease awareness group (23.8% vs. 7.7%; p = .003 by the log‐rank test).ConclusionsPoor disease awareness was linked to poor medication adherence, lifestyle‐related diseases, and greater LAV before and even 1 year after the ablation, making it a potential surrogate marker for AF/AT recurrence. These findings highlight the clinical significance of disease awareness in AF management.

show abstract

Polish regional differences in patient knowledge on atrial fibrillation and its management as well as in patterns of oral anticoagulant prescription

Cited by 15 publications

References 8 publications

Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Permanent atrial fibrillation in patients with a dual‑chamber pacemaker

Minor bleeding affects the level of knowledge in patients with atrial fibrillation on oral anticoagulant therapy

Clinical implication of the patient's disease awareness and adherence to medications in patients undergoing atrial fibrillation ablation

Contact Info

Product

Resources

About