Warfarin Research Paper

Warfarin Research Paper-24
The study objective was to evaluate the patients’ knowledge about warfarin and assess the impact of the health care professionals’ counselling in enhancing patients’ knowledge in achieving warfarin therapeutic outcomes.A six-month prospective multicentered study was conducted in three hospitals, enrolling 300 patients admitted to the cardiac care unit and internal medicine departments.A higher mean knowledge about warfarin score was found after counselling as compared to before counselling (4.82 vs 13.2; p Vitamin K antagonists, namely warfarin, remain one of the main oral anticoagulant treatments used for the prevention and treatment of cardiac, thromboembolic and hypercoagulable diseases [1,2,3,4].

The study objective was to evaluate the patients’ knowledge about warfarin and assess the impact of the health care professionals’ counselling in enhancing patients’ knowledge in achieving warfarin therapeutic outcomes.A six-month prospective multicentered study was conducted in three hospitals, enrolling 300 patients admitted to the cardiac care unit and internal medicine departments.A higher mean knowledge about warfarin score was found after counselling as compared to before counselling (4.82 vs 13.2; p Vitamin K antagonists, namely warfarin, remain one of the main oral anticoagulant treatments used for the prevention and treatment of cardiac, thromboembolic and hypercoagulable diseases [1,2,3,4].

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As part of the effective anticoagulation management, frequent INR monitoring, dose alteration, and patient’s education are also necessary.

Therefore, a health care professional (clinical pharmacist or physician) provided an oral counselling session for the patients to raise their level of awareness after the baseline assessment.

A two-page brochure entitled “Warfarin: Understanding Side Effects and the Importance of Compliance” was prepared and distributed by the clinical pharmacist at the end of the face-to-face session.

To assess patient’s adherence to treatment, we used the Medication Possession Ratio (MPR), defined as the proportion (or percentage) of days’ supply obtained over either refill interval, where last refill is the end point, or fixed refill, where a specific time period is set [20].

A sample of 203 patients was targeted to allow for adequate power for bivariable and multivariable analyses to be carried out according to the Epi info sample size calculations with a population size of 4 million in Lebanon, a 15.7% expected frequency of knowledge about warfarin treatment [21], a 5% confidence limits [22].

We decided to distribute 350 questionnaires to take refusals into account.A cross-sectional population-based prospective multicentered study was conducted between January and June 2016.Patients were recruited from three urban Lebanese university hospitals chosen randomly from the list of hospitals provided from the Lebanese Order of Pharmacists.Warfarin has a long half-life; following a single dose, the terminal elimination half-life is about 1 week, with a mean effective half-life of 40 h [27].Individual verbal and written counselling was provided to each participant.Indeed, warfarin is listed among the top ten drugs to cause the largest number of serious adverse events reported during the last two decades, according to the adverse events reporting system of the Food and Drug Administration [3].Achievement of therapeutic outcomes in patients maintained on warfarin is hindered because it is associated with significant inter-patient variability related to age, gender, ethnicity, body weight and genetic variations, and a wide range of drug interactions [10, 11].Patients’ warfarin knowledge and INR levels were assessed before and after the clinical pharmacist counselling.The main therapeutic outcome was the impact of the clinical pharmacist-physician counselling on improving patient’s education and achieving therapeutic INR level.Fib), valve disease/replacement, stroke or Systolic Left Ventricular Dysfunction (SLVD) were enrolled in this study.Excluded from the analysis were patients who could not answer the questionnaire adequately either due to a decreased mental alertness or decreased cognitive function (cognitive disorders, sedated patients, Alzheimer’s disease, etc.).

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