Supervisors info:
Νικόλαος Φώτος, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Ηρώ Μπροκαλάκη, Ομότιμη Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Κωνσταντίνος Γιακουμιδάκης, Αναπληρωτής Καθηγητής, Τμήμα Νοσηλευτικής, ΠΑΔΑ
Summary:
Introduction: Atrial fibrillation (AF) is the most common cardiac arrhythmia and is associated with an increased risk of thromboembolic stroke. Taking anticoagulant treatment may significantly reduce the risk of thromboembolic stroke and the effectiveness of treatment depending on the degree of adherence of patients to it.
Aim: To assess the knowledge of patients with AF for anticoagulant treatment and the level of adherence to this treatment.
Material and Methods: This is a cross-sectional study involving 97 patients with AF who were hospitalized at a cardiology clinic in General Hospital of Athens, Greece, from December 2017 to April 2018. For the data collection, the following tools were used: «Anticoagulant Knowledge Tool» (AKT), «A14-scale» and «Adherence Barrier Questionnaire» (ABQ). For the management and statistical analysis of the results, the IBM SPSS 22.0 package was used. The level of statistical significance was set at 0.05.
Results: The mean age of participants in the study was 71.88 years (SD=10.7 years) and the majority of them were females (52.6%). Most patients (57.7%) suffered from paroxysmal AF. The level of knowledge of patients for oral anticoagulation was satisfactory, but not high, as shown by the mean score at AKT (24.48). The type of AF, and in particular the persistent AF, as well as the reception of newer anticoagulants were associated with lack of knowledge (p=0.031 and p<0.001, respectively). The majority of patients (56.6%) were not adherent to anticoagulant treatment and they reported the existence of barriers in their efforts to adhere to treatment. Elderly and low-educated patients showed poor adherence to anticoagulant therapy (p <0.001 and p = 0.034, correspondingly), while the presence of obstacles was related to older age, increased duration of hospitalization, and high number of visits to the emergency department for AF (p <0.001, p = 0.003 and p = 0.026, respectively).
Conclusions: Most patients in the study are not adherent to anticoagulant therapy, and their level of knowledge about anticoagulation is satisfactory but not high. At the same time, the majority of patients reported a significant influence of barriers that affecting their adherence to treatment. Obviously, health care professionals, and nurses among them, should focus on the problem of poor adherence to anticoagulation and systematically engage in the education of those patients.
Keywords:
Anticoagulant treatment, Knowledge, Atrial fibrillation, Adherence
