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BPharm Student, School of Pharmacy, The Chinese University of Hong Kong, Hong Kong
BPharm Student, School of Pharmacy, The Chinese University of Hong Kong
Associate Professor, School of Pharmacy, The Chinese University of Hong Kong
Medical Officer, Department of Medicine and Therapeutics, Prince of Wales Hospital, Shatin, Hong Kong
Associate Professor and Consultant Hematologist, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital
Professor and Consultant Physician, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital
Reprints: Thomas YK Chan MBChB MD PhD FRCP, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, New Territories, Hong Kong, FAX 852/2632-3108, E-mail tykchan{at}cuhk.edu.hk
OBJECTIVE: To evaluate patients' knowledge of warfarin and its relationship to anticoagulation control.
METHODS: From January to March 1999, 122 patients attending the warfarin clinic of the Prince of Wales Hospital in Hong Kong were interviewed. Their knowledge of warfarin therapy and adherence to medical advice were tested by 9 questions. A score (maximum 1.0) was calculated for each patient. The number of international normalized ratios (INRs) that was within the target range in the 4 most recent clinic visits was noted.
RESULTS: Fifty-six men and 66 women participated in the study (mean ± SD age 58.0 ± 13.0, duration of treatment 43.1 ± 39.8 mo). Patients' warfarin knowledge was poor, with an overall score of 0.48 ± 0.18. Participants generally knew the colors of their warfarin tablets and took them regularly. They almost always informed their physicians and dentists of their warfarin therapy. Only 40–45% of patients knew the strengths of their warfarin tablets, the reason for taking warfarin, and its effect on the body. Their deficiencies in knowledge were even more obvious with respect to the possible consequences of under- or over-anticoagulation, drugs and medicated oils that might interact with warfarin, and management of a missed dose. Knowledge was related to age (r –0.43; p < 0.001) and duration of therapy (r 0.18; p = 0.044). Sixty patients (49.2%) had read the information booklet on warfarin and had better knowledge than those who had not (0.53 ± 0.20 vs. 0.42 ± 0.20; p < 0.001). Illiteracy was the main reason for not reading the booklet. There was a positive correlation between patients' warfarin knowledge and the number of INR values that was within the target range in the 4 most recent clinic visits (r 0.20; p = 0.024).
CONCLUSIONS: Patients' warfarin knowledge, a determinant of anticoagulation control, was generally poor. More attention should be given to the education of elderly and illiterate patients.
Key Words: patient education, warfarin
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