Psychometric Properties and Construct Validity of the Knowledge Information Profile–Coumadin

Abstract

Coumadin (warfarin) is an oral anticoagulant used to prevent blood clots in conditions such as atrial fibrillations, stroke, and deep vein thrombosis. Coumadin is the second most common drug-after insulin-implicated in emergency room visits for adverse drug reactions. 1 These adverse reactions can range from minor complications (bleeding from gums, blood in urine, bloody or dark stool, nosebleed) to systemic complications resulting in life-threatening interactions that can cause severe, possibly fatal bleeding. The primary high-risk factor associated with Coumadin is bleeding related to high intensity of the international normalized ratio (INR > 4.0) or to the patients' age (65 years and older). The risk factors make patient knowledge, medication adherence, and the ability to safely manage medication administration critical to maintaining therapeutic anticoagulation balance. In response to this concern, a 20-item measure titled the Knowledge Information Profile-Coumadin (KIP-C20) was developed by the study's principal investigator (PI) to assess patient knowledge of Coumadin. Instrument development began with a search of the literature that included actions, side effects, diet, and self-care medication management and current treatment modalities of Coumadin. The purpose of this research was to examine the reliability and construct validity of the KIP-C20 in a large sample (N = 192) of outpatients recruited from pharmacist-directed anticoagulation clinics and to address the following questions: 1. What is the reliability of the KIP-C20 in this sample of patients? 548594P MTXXX10.

Relation between health literacy, self-care and adherence to treatment with oral anticoagulants in adults: a narrative systematic review

“…The variables collected in the studies were mainly sociodemographic, including the level of income in four articles [ 36 – 39 ]; others also collected data about medical history, including INR or TTR, although two articles did not have this marker [ 39 , 40 ]. Different tools were used to assess cognitive ability, including the Cognitive Abilities Screening Instrument-Short Form (S-CASI), Short Portable Mental Status Questionnaire (SPMSQ), Animal Naming Test (ANT) and the ABILHAND (to measure of manual ability for adults) [ 34 , 39 – 43 ].…”

“…No papers published in Europe were found. The most recent articles were published between 2014 and 2015 [ 37 , 40 ].…”

“…Of note, there were no tools validated in other Spanish-speaking populations. The most frequently validated tool used to measure HL was the short version of the Test of Functional Health Literacy in Adults (S-TOFHLA), present in six articles [ 36 , 37 , 39 , 41 – 43 ] and the Rapid Estimate of Adult Literacy in Medicine (REALM) scale used in four articles [ 34 , 35 , 38 , 40 ].…”

“…In seven studies about 50–60% of participants had limited or inadequate HL, [ 36 , 37 , 39 – 43 ] studies used S-TOFHLA, whilst one employed the REALM tool. [ 40 ] Three studies (using REALM) obtained a prevalence of limited HL of 12–15% and adequate HL of around 70–80% [ 34 , 35 , 38 ].…”

“…All selected studies directly related HL levels to educational or reading levels. In four studies the participants’ annual income was included, [ 36 – 38 , 40 ] but only one paper directly related it to the level of HL [ 37 ].…”