Factors Associated with Warfarin Therapy Knowledge and Anticoagulation Control among Patients Attending a Warfarin Clinic in Malaysia
1663-1670
Correspondence
Mohamed Azmi Ahmad Hassali,
Ph: +6046533888 ext. 4085,Fax: +604-6570017.
E-mail address:azmihassali@usm.my
Objective: To determine the factors that correlated with the patient’s knowledge of warfarin therapy, the level of medication adherence and INR control.
Methods: A cross-sectional survey was conducted at the Warfarin Clinic of Hospital Teluk Intan, Malaysia. The systematic random sampling method was used in sample selection and face-to-face interviews using standard questionnaires were administered to determine the demographic characteristics, the patient’s knowledge of warfarin therapy and medication adherence. Medical records were reviewed to determine anticoagulation control during the study period.
Results: A total of 52 patients were enrolled in the survey (mean ± SD age of 58.73 9.55 years), with a response rate of 95%. A large proportion (63.5%) of the respondents had only primary school education and 71.2% were low-income earners (below RM500 per month). About 69% of the respondents were able to read and 53.8% were able to understand Malay (the national language of the country). A majority of the patients (98%) had verbal medication education through medical or nursing officers. Only 44.2% of patients knew about their medications, but the medication adherence was fairly good at 76.1%. The study showed that age, income level, level of education, and literacy in various languages were significantly associated with the patient’s knowledge on warfarin therapy (p< 0.05). The study also showed a significant difference between those patients who knew/did not know about their medications in terms of warfarin therapy knowledge (p<0.05).
Conclusion: Age, income, educational level, literacy and race were significantly correlated with the patient’s knowledge of anticoagulation. The study did not find any association between anticoagulation control and the knowledge of anticoagulation.
Practice Implications: The disadvantaged groups receiving anticogulation therapy, including the low-income earners, the elderly, the less-educated and the illiterate, should be given utmost care and attention.