Assessment of emergency department patients’ knowledge on oral anticoagulation therapy

Abstract

Objectives:
Oral anticoagulant therapy (OAT) is a frequent reason for emergency department visits due to resulting trombotic and bleeding complications because of its narrow therapeutic range. Patient education on OAT use has been described as a vital component for successful therapy. The aim of this study was to assess current knowledge of patients receving OAT.
Methods:
Patients presenting to adult emergency department who are on OAT were asked to complete a questionnaire created by authors. Patient demographics, as well as the knowledge and sources of education they received about OAT were evaluated. Chi-square tests were used to compare associated factors to OAT knowledge.
Results:
Mean age of 122 patients included in the study was 64±14. Of all patients 37.7% were male, 51.6% were >65 years of age and 33.6% were illiterate. 61.5% (n=75) of patients were aware of bleeding risk of OAT and 70.5% (n=86) of the need for regular blood tests. Only 15.6% (n=19) of patients knew about drug interactions of OAT while 10.7% (n=13) knew about its dietary interactions. 64.8% (n=79) patients reported being informed about OAT. Source of information was prescribing doctor in 27% (n=33) of patients.
Knowledge of bleeding risk was significantly lower in patients older than 65 (p=0.002). Education in any level of school was associated with the knowledge of bleeding risk (p=0.011), drug (p=0.049) and dietary (p=0.034) interactions. While receiving education of OAT was associated with the knowledge of bleeding risk (p<0.001) and need for regular blood tests (p<0.001), it was not associated with the knowledge of drug (p=0.095) and dietary interactions (p=0.54).
Conclusion:
Considering the complications of unsuccessful OAT, level of knowledge of patients on OAT was quite low. Increasing the awareness of treating physicians and providing education for patients on OAT with standardized validated methods is required.