Warfarin Adherence and Its Associated Factors in Thai Older Adults with Atrial Fibrillation

IF 2.7 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Journal of Multidisciplinary Healthcare Pub Date : 2024-09-14 DOI:10.2147/jmdh.s472597

Autchariya Poungkaew, Thitipong Tankumpuan, Chontira Riangkam, Junporn Kongwatcharapong, Tassanee Daekunthod, Khachol Sriyayang, Rungroj Krittayaphong, Binu Koirala

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引用次数: 0

Abstract

Introduction: Older people mostly found unable to adhere with warfarin treatment guidelines. The health service system is challenged in order to improve medication adherence in older population under limited health resources. The purpose of this study was to explore health systems factors on warfarin adherence in older population, particularly in resources constraint setting.
Methods: This study was a cross-sectional predictive study that enrolled older people who experienced atrial fibrillation (AF) and treated by warfarin, aged 60 years and over, and followed up at the warfarin clinic.
Results: A total of 197 participants with the mean age of 72.03 years (SD = 8.84) was recruited. Almost of them (85.8%) reported adhered to warfarin prescription. More than a half (60.5%) were able to report their targeted INR. Participants who stayed with the family had 5.54 times (95% CI 1.79– 19.33), took regular daily dose warfarin had 5.07 times (95% CI 1.05– 24.49), perceived targeted INR had 2.94 times (95% CI 1.04– 8.29), and received family support had 1.33 times (95% CI 1.11– 1.60) increased odds of warfarin adherence than those who did not. Participants who perceived a barrier to taking medication had 0.93 times decreased odds of warfarin adherence than those who did not (95% CI 0.86– 0.99).
Conclusion: Healthcare system should encourage family to support the older population with AF in order to increase warfarin adherence. Future research should develop intervention combining family support to promote warfarin adherence.

Keywords: adherence, atrial fibrillation, INR, older population, warfarin

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泰国心房颤动老年人的华法林依从性及其相关因素

简介老年人大多无法遵守华法林治疗指南。在医疗资源有限的情况下，如何提高老年人的用药依从性对医疗服务系统提出了挑战。本研究旨在探讨卫生系统对老年人群华法林用药依从性的影响因素，尤其是在资源有限的情况下：本研究是一项横断面预测性研究，研究对象为60岁及以上接受华法林治疗的心房颤动（房颤）老年人，并在华法林门诊进行随访：共招募了 197 名参与者，平均年龄为 72.03 岁（SD = 8.84）。几乎所有参与者（85.8%）都表示遵守了华法林处方。半数以上（60.5%）的参与者能够报告其目标 INR。与家人住在一起的参与者的华法林依从性是不与家人住在一起的参与者的 5.54 倍（95% CI 1.79-19.33），每天按时服用华法林的参与者的依从性是不与家人住在一起的参与者的 5.07 倍（95% CI 1.05-24.49），认为自己的目标 INR 是不与家人住在一起的参与者的 2.94 倍（95% CI 1.04-8.29），获得家人支持的参与者的依从性是不与家人住在一起的参与者的 1.33 倍（95% CI 1.11-1.60）。认为服药有障碍的参与者坚持服用华法林的几率比没有障碍的参与者降低了 0.93 倍（95% CI 0.86-0.99）：医疗系统应鼓励家人支持老年房颤患者，以提高华法林的依从性。未来的研究应开发与家庭支持相结合的干预措施，以促进华法林的依从性。关键词：依从性；心房颤动；INR；老年人群；华法林

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来源期刊

Journal of Multidisciplinary Healthcare Nursing-General Nursing

CiteScore

4.60

自引率

3.00%

发文量

287

审稿时长

16 weeks

期刊介绍： The Journal of Multidisciplinary Healthcare (JMDH) aims to represent and publish research in healthcare areas delivered by practitioners of different disciplines. This includes studies and reviews conducted by multidisciplinary teams as well as research which evaluates or reports the results or conduct of such teams or healthcare processes in general. The journal covers a very wide range of areas and we welcome submissions from practitioners at all levels and from all over the world. Good healthcare is not bounded by person, place or time and the journal aims to reflect this. The JMDH is published as an open-access journal to allow this wide range of practical, patient relevant research to be immediately available to practitioners who can access and use it immediately upon publication.