 |
 |
 |
 |
 |
 |
 |
|
|
|
|||||||||
|
|||||||||||
Assistant Professor, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, NY
Director, Clinical Hematology, Einstein–Weiler Hospital; Professor, Clinical Medicine and Pathology, Montefiore Medical Center and Albert Einstein College of Medicine
Assistant Professor of Epidemiology and Population Health, Albert Einstein College of Medicine
Chief, Division of General Internal Medicine; Associate Professor of Medicine, Epidemiology, and Psychiatry, Albert Einstein College of Medicine and Montefiore Medical Center
Reprints: Dr. Davis, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, 1621 Eastchester Rd., Bronx, NY 10461-2601, fax 718/405-8045, ndavis{at}montefiore.org
BACKGROUND: Patients receiving chronic warfarin therapy who have poor anticoagulation control are at increased risk for adverse events. However, it is unknown how adherence to warfarin, patient demographics, patient knowledge about therapy, and perceived impact of warfarin therapy on quality of life are associated with anticoagulation control.
OBJECTIVE: To determine the association between these patient factors and anticoagulation control in patients attending 2 anticoagulation clinics in the Bronx, New York City.
METHODS: A cross-sectional survey of 52 patients was conducted. The
4-item Morisky survey was used to assess self-reported adherence. Patient
knowledge about warfarin therapy and the perceived impact of warfarin therapy
on quality of life were determined by self-administered questionnaires.
Associations between adherence, patient knowledge, impact of warfarin therapy
on quality of life, and anticoagulation control were determined with
t-tests, 
2 analysis, and logistic regression.
RESULTS: Only 14% of patients had good anticoagulation control. Adequate adherence was reported by 50% of patients and was significantly associated with good anticoagulation control (p = 0.01). Thirty-seven percent of participants had good knowledge of anticoagulation, and 19% of participants reported that warfarin negatively impacted their quality of life. Knowledge about warfarin therapy and impact of warfarin on quality of life were not significantly associated with anticoagulation control.
CONCLUSIONS: Adherence is one of many factors that contribute to anticoagulation control. Adequate adherence, as determined by the Morisky survey, was significantly associated with anticoagulation control. Patient demographic characteristics, knowledge about warfarin therapy, and perceived impact of warfarin on quality of life were not associated with anticoagulation control.
Key Words: adherence, anticoagulation, warfarin
Published Online, February 15, 2005. www.theannals.com, DOI 10.1345/aph.1E464
This article has been cited by other articles:
|
|
 |
|
  E. Sconce, P. Avery, H. Wynne, and F. Kamali Vitamin K supplementation can improve stability of anticoagulation for patients with unexplained variability in response to warfarin Blood, March 15, 2007; 109(6): 2419 - 2423. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. E. Kimmel, Z. Chen, M. Price, C. S. Parker, J. P. Metlay, J. D. Christie, C. M. Brensinger, C. W. Newcomb, F. F. Samaha, and R. Gross The Influence of Patient Adherence on Anticoagulation Control With Warfarin: Results From the International Normalized Ratio Adherence and Genetics (IN-RANGE) Study Arch Intern Med, February 12, 2007; 167(3): 229 - 235. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M Zeolla, M. R Brodeur, A. Dominelli, S. T Haines, and N. D Allie Development and Validation of an Instrument to Determine Patient Knowledge: The Oral Anticoagulation Knowledge Test Ann. Pharmacother., April 1, 2006; 40(4): 633 - 638. [Abstract] [Full Text] [PDF]
|
|
 |
 |
 |
 |
 |
 |
 |
