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ANTICOAGULATION

Development and Validation of an Instrument to Determine Patient Knowledge: The Oral Anticoagulation Knowledge Test

Assistant Professor, Department of Pharmacy Practice, Albany College of Pharmacy, Albany, NY

Michael R Brodeur, PharmD

Assistant Professor, Department of Pharmacy Practice, Albany College of Pharmacy

Angela Dominelli, PhD

Assistant Professor of Pharmacy Administration, Department of Humanities and Social Sciences, Albany College of Pharmacy

Stuart T Haines, PharmD

Professor and Vice-Chair for Education, Department of Pharmacy Practice and Science, School of Pharmacy, University of Maryland, Baltimore, MD

Nicole D Allie, PharmD

Clinical Pharmacist, Pharmacy Administration, Harvard Vanguard Medical Associates, Watertown, MA

Reprints: Dr. Zeolla, Department of Pharmacy Practice, Albany College of Pharmacy, 106 New Scotland Ave., Albany, NY 12208-3492, fax 518/694-7302, zeollam{at}acp.edu

BACKGROUND: Studies examining the relationship between patient knowledge regarding warfarin therapy and its safe and effective use are limited by the lack of validated knowledge assessment tools.

OBJECTIVE: To develop and validate an instrument to assess patient knowledge regarding oral anticoagulation therapy.

METHODS: Four nationally recognized anticoagulation experts participated in the instrument development process to ensure content validity. The Oral Anticoagulation Knowledge (OAK) test was administered to subjects on warfarin and a group of age-matched subjects not on warfarin to assess construct validity. A subgroup of warfarin subjects were retested approximately 2-3 months after initial testing to assess test-retest reliability. Internal consistency reliability was assessed by calculating a Kuder-Richardson 20 value. Item analysis was used to assess performance of individual questions.

RESULTS: An initial 23 item instrument was pilot tested for readability and comprehension. The OAK test was administered to 74 subjects taking warfarin and 27 age-matched subjects not on warfarin. Thirty-two subjects on warfarin repeated the OAK test an average of 75 days following initial administration. Subjects taking warfarin scored significantly higher than those not on warfarin (72% vs 52%, respectively; p < 0.001), supporting the construct validity of the instrument. Test-retest reliability was acceptable, with a Pearson's correlation coefficient of 0.81. Internal consistency reliability was confirmed by a calculated Kuder-Richardson 20 value of 0.76.

CONCLUSIONS: The OAK test is a brief, valid, and reliable knowledge assessment instrument that may be a useful tool for research and clinical practice to augment patient education programs.

Key Words: anticoagulation, patient knowledge, warfarin

Published Online, March 21, 2006. www.theannals.com, DOI 10.1345/aph.1G562

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