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Implementation and scale-uping of Text Messages for primary care patients using Warfarin: a real life study

1Universidade Federal de Viçosa - UFV, Belo Horizonte, Minas Gerais, Brazil, 2Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil, 3Universidade Federal de São João Del-Rei., Belo Horizonte, Minas Gerais, Brazil, 4FCMMG, Belo Horizonte, Minas Gerais, Brazil, 5Universidade Federal de São João Del-Rei, Divinópolis, Minas Gerais, Brazil, 6UFMG, Belo Horizonte, Minas Gerais, Brazil, 7Universidade Federal de Minas Gerais., Belo Horizonte, Minas Gerais, Brazil, 8Associate Professor and Internal Medicine Physician. Department of Internal Medicine, Medical School; and Telehealth Center, University Hospital, Universidade Federal de Minas Gerais., Belo Horizonte, Minas Gerais, Brazil

Abstract Number: VPB0568

Meeting: ISTH 2022 Congress

Theme: Coagulation and Natural Anticoagulants » Coagulation Factors and Inhibitors

Background: Warfarin remains the most available oral anticoagulant, however therapy depends on adhesion. The use of text-messages is a strategy that can be used to educate patients, but there are no studies evaluating this intervention in patients taking warfarin.

Aims: Our aim was to report the implementation of a pilot text-messaging intervention to primary care patients taking warfarin in a middle-sized Brazilian city.

Methods: A bank of 79 messages was drafted and validated. During six months, three times a week, 37 patients received semi-personalized messages about anticoagulation with warfarin. At baseline and after three months, we assessed their knowledge and adherence with validated questionnaires. At the end of the follow-up, participants answered a satisfaction questionnaire. Subsequently, a scale-up stage was conducted, with an additional round of intervention including 82 patients. Seven months after the end of the second round, we interviewed the patients for their insights about the long-term effects of this program. All patients signed informed consent. The study was approved by the Research and Ethics committee of the Universidade Federal de Minas Gerais.

Results: In the first round, 33 (89.2%) patients completed the follow-up. Adherence measured by the MAT test was high in the pre-intervention assessment and remained high after three months (96.7% vs. 93.3%). There was a trend to improve knowledge of warfarin therapy measured by the OAK test after three months (6.5% to 25.6% of correct answers, p = 0.0703). In the scale-up phase, 23 patients were interviewed in the long-term assessment. The main long-term knowledge they reported was dietary information. Nine patients reported to have received the messages, but did not remember their content.

Conclusion(s): The intervention was well-accepted by the patients, and had a positive impact on their knowledge about oral anticoagulation therapy. The scale-up assessment showed the need to constantly monitor digital interventions.

To cite this abstract in AMA style:

CHAGAS V, Rego Souza-Silva M, Paiva Domingues M, Pereira D, Sá L, Almeida M, Raposo M, Oliveira J, Soares T, Baldoni A, Marcolino M, Parreiras Martins M. Implementation and scale-uping of Text Messages for primary care patients using Warfarin: a real life study [abstract]. https://abstracts.isth.org/abstract/implementation-and-scale-uping-of-text-messages-for-primary-care-patients-using-warfarin-a-real-life-study/. Accessed October 1, 2023.

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