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EmpoderACO: Elaboration and Validation of a Protocol for Behavioral Change in Patients on Warfarin

1Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, Brazil, 2Universidade Federal de Minas Gerais, Faculdade de Letras, Belo Horizonte, Brazil, 3Universidade Federal de Minas Gerais, Instituto de Ciências Exatas, Belo Horizonte, Brazil, 4Universidade Federal do Recôncavo da Bahia, Colegiado de Enfermagem, Belo Horizonte, Brazil, 5Universidade Federal de Minas Gerais, Faculdade de Farmácia, Belo Horizonte, Brazil, 6Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, Brazil

Abstract Number: PB2427

Meeting: ISTH 2020 Congress

Theme: Venous Thromboembolism and Cardioembolism » VTE Treatment

Background: Warfarin is an oral anticoagulant widely used for primary and secondary thromprophylaxis. It has a narrow therapeutic index and wide variability in dose-response, requiring frequent monitoring and assistance. Anticoagulation control with warfarin remains a challenge. Patients on warfarin could benefit from educational strategies focusing on changing behavior, to improve individual’s active participation in self-care and adherence to drug therapy.

Aims: To elaborate and validate the EmpoderACO, a protocol for behavioral change in patients on warfarin.

Methods: The instrument was developed as following: elaboration of the initial version of the protocol by specialists; multiple rounds of corrections of the instrument; pre-testand adaptations before releasing its final version. The relevance, adequacy and clarity of each item of the instrument were evaluated by a multiprofessional committee of judges using the E-Surv platform. The internal reliability was calculated using the content validity coefficient (CVC) of the evaluation of the judge’s committee. The pre-test involved 30 patients on warfarin assisted at an anticoagulation clinic of a university hospital in Brazil. At this phase, patients made a comprehensive evaluation of the protocol items.

Results: The self-care domains covered in the protocol were: understanding and satisfaction of treatment, reduction of adverse events; and promoting well-being and healthy habits. Overall, 34 professionals participated of the committee of judges, including: physicians, nurses, pharmacists, nutritionists, linguistsand a pedagogue. The CVC was considered satisfactory with a compliance CVC>0.91 of the items for relevance, adequacy and clarity. The clarity of the instrument assessed by the patients, in the pre-test, obtained an average CVC of 0.96.

Conclusions: The protocol EmpoderACO may contribute to the design of educational strategies to improve patients´ understanding of their own health problem and drug therapy, communication process between professionals and patients, and decision-making process.

Acknowledgment: This study received partial support from CNPq, CAPES and FAPEMIG.

To cite this abstract in AMA style:

Barbosa HC, Pagano AS, Reis IA, Praxedes MFdS, Da Costa JM, Torres HDC, Martins MAP. EmpoderACO: Elaboration and Validation of a Protocol for Behavioral Change in Patients on Warfarin [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/empoderaco-elaboration-and-validation-of-a-protocol-for-behavioral-change-in-patients-on-warfarin/. Accessed September 21, 2023.

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