Factors Associated with Warfarin Therapy Knowledge and Anticoagulation Control among Patients Attending a Warfarin Clinic in Malaysia
Mohamed Azmi Ahmad Hassali,
Ph: +6046533888 ext. 4085,Fax: +604-6570017.
Objective: To determine the factors that correlated with the patientâ€™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 patientâ€™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 Â± 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 patientâ€™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 patientâ€™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.