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The Impact of an Educational Intervention in Patients with Atrial Fibrillation Treated with Warfarin

1Universidade Federal de Minas Gerais, Faculdade de Farmácia, Belo Horizonte, Brazil, 2Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, Brazil, 3Universidade Federal de Minas Gerais, Escola de Enfermagem, Belo Horizonte, Brazil, 4Universidade Federal de Minas Gerais, Instituto Ciências Biológicas, Belo Horizonte, Brazil, 5Universidade Federal do Recôncavo da Bahia, Colegiado de Enfermagem, Santo Antônio de Jesus, Brazil, 6Universidade Federal de Minas Gerais, Faculdade de medicina, Belo Horizonte, Brazil, 7Universidade Federal de Minas Gerais, Hospital das Clínicas, Belo Horizonte, Brazil

Abstract Number: PB2422

Meeting: ISTH 2020 Congress

Theme: Venous Thromboembolism and Cardioembolism » VTE Treatment

Background: Educational interventions are of utmost importance for oral anticoagulation control of patients taking warfarin.

Aims: To assess the impact of a patient-centered educational strategy focused on low-income patients with poor anticoagulation control with warfarin.

Methods: Non-randomized controlled study. Adult patients with atrial fibrillation with time in therapeutic range (TTR) < 60% were recruited at two anticoagulation clinics (ACs) inBelo Horizonte, Southeast Brazil. Intervention group received 4 educational sessions based on patient-centered care approach and one telephone call between each session, in addition to usual care. Control group received usual care only. The intervention lasted four months. We assessed TTR and warfarin knowledge (Oral Anticoagulation Knowledge [OAK]test) before and after intervention. Health literacy was assessed on baseline using SHALPA-18. All participants signed an informed consent form (CAAE 65928316.3.0000.5149, REBEC RBR-9cy6ty and UTN U1111-1217-0151). Intention-to-treat analysis was performed.

Results: Through the study, 168 patients were included: 83 to intervention group (63±12 years-old, 35% male, 60% with inadequate health literacy) and 85 to control group (68±14 years-old, 52% male, 75% with inadequate health literacy). Most patients allocated to the intervention (92%) participated of at least one face-to-face meeting, 16% participated in all four sessions. When comparing intervention and control groups, there was an increase in the median change of hits in the OAK test (2[interqualite range 0-5] intervention vs.1[interqualite range -2-3] control, p=0.036). There was no significant difference in the median TTR change between groups (11[interquartile range 1-29]% vs. 20[interquartile range -7-43]%, p=0.69). The number of patients who increased TTR in intervention group was greater than the controls (77% vs. 65%), although this difference was not statistically significant (p=0.10).

Conclusions: The study suggests a patient-centered educational intervention may contribute to improve warfarin knowledge, but further studies with large sample sizes are necessary to assess the impact on anticoagulation control.
Acknowledgments: CNPq, CAPES, FAPEMIG.

To cite this abstract in AMA style:

Costa JM, Marcolino MS, Torres HC, Souza RP, Praxedes MFS, Barbosa HC, Barros SDS, Viegas AC, Nascimento DV, Ferreira CB, Antunes NS, Silva ACR, Ribeiro DD, Martins MAP. The Impact of an Educational Intervention in Patients with Atrial Fibrillation Treated with Warfarin [abstract]. Res Pract Thromb Haemost. 2020; 4 (Suppl 1). https://abstracts.isth.org/abstract/the-impact-of-an-educational-intervention-in-patients-with-atrial-fibrillation-treated-with-warfarin/. Accessed October 1, 2023.

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