Relationship Between Anticoagulant Medication Adherence and Satisfaction in Patients With Stroke

Abstract

AIM: The aim of this study was to investigate the accuracy of the self-reported measure of adherence and the relation between adherence to warfarin use, demographic and clinical variables, and the satisfaction with the treatment in patients affected by stroke. METHODS: This is a correlational, quantitative, and cross-sectional study, carried out in the outpatient clinics of a public university hospital from October 2017 to April 2018. Sociodemographic and clinical data were collected through interviews and hospital charts, as well as by applying the Measurement of Treatment Adherence (MTA) and the Duke Anticoagulation Satisfaction Scale, in their Brazilian versions. Results of the international normalized ratio (INR) were collected. Measurements of accuracy of the MTA scale were calculated in relation to the INR classification. RESULTS: Of 99 patients (55.6% male with a mean age of 58.6 years), 57.6% presented with therapeutic INR values and 75.8% of the patients were adherent to the oral anticoagulant therapy according to the MTA. The accuracy analysis of the measurement provided by the MTA scale in relation to the INR classification showed a sensitivity of 77.2% and a specificity of 26.2%. The patients’ satisfaction with the treatment was high. The Duke Anticoagulation Satisfaction Scale had an average total score of 46.4, with the dimension impact in the field having the highest score (20.3). CONCLUSION: Stroke patients were adherent and satisfied with the oral anticoagulant therapy. The MTA had good sensitivity and poor specificity. Sociodemographic and clinical characteristics identified were not associated with adherence and satisfaction with treatment.

Self-report instruments for assessing adherence to warfarin therapy: a systematic review

“…A total of 1156 records were retrieved after running the initial search. Overall, 19 studies [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28][29][30][31] met the inclusion criteria of this systematic review, being selected for qualitative synthesis. A manual search was performed, with no identification of any study meeting the eligibility criteria.…”

“…Seventeen cross-sectional studies, one cohort study, and one quasi-experimental study were included, with a publication range from 2009 to 2019. Brazil was the most cited country for the conduction of studies [19,22,25], followed by Australia [21,23], Saudi Arabia [14,24], and China [26,31]. The language of publication was English for most articles, except for one article [17] published in Portuguese from Portugal and for tree articles [19,22,25], published in Brazilian Portuguese.…”

“…Only six studies [13,14,20,27,29,31] presented the minimum length of oral anticoagulation, ranging from three to six months. Some of these [16,22,25,27] reported the average time of oral anticoagulation,…”

“…The MMAS instrument was used in its original format in studies that used it [14,16,19,27,28,30], while MMAS-8 was used in the original format in only three studies [20,21,29]. The MTA scale was used in the Portuguese version developed in Portugal in two studies [17,22], while the BMQ scale was used in its original version in one of the studies [18] and in the Portuguese version developed in Brazil in another [17].…”

Instrumen Monitoring Pasien Dalam Terapi Warfarin

“…Pertama, penelitian yang dilakukan oleh Almeida et.al pada tahun 2011 di brazil terhadap 72 pasien penderita atrial fibrillation dan mechanical heart valve menunjukan bahwa skor rata-rata 67,1 hal tersebut menunjukan bahwa kualitas hidup pasien cukup baik10 . Hasil penelitian tersebut sejalan dengan penelitian yang dilakukan oleh Oliveira-Kumakura et.al pada tahun 2019 di Brazil terhadap 99 orang pasien rawat jalan penderita stroke menunjukan skala kepuasan pengobatan antikoagulasi dengan warfarin memiliki skor total rata-rata 46,4 hal tersebut menunjukan bahwa pasien stroke merasa cukup puas dengan pengobatan yang menyebabkan kualitas hidup pasien meningkat11 . Dalam artikel penelitian yang dilakukan oleh Almeida et.al pada tahun 2011 di brazil terhadap 72 pasien penderita atrial fibrillation dan mechanical heart valve menunjukan bahwa SF-36 menyajikan skor rata-rata 62,2 yang artinya kualitas hidup pasien yang dinilai menggunakan SF-36 adalah cukup baik.…”