Assessment of Knowledge and Medication Adherence Among Patients Prescribed with Oral Anticoagulants in Atrial Fibrillation at a Tertiary Care Centre: A Cross Sectional Study.

Abstract

Purpose: Atrial fibrillation (AF) being a prevalent cardiovascular condition globally, has an increased risk of stroke and other complications. The effective management of AF often involves the use of oral anticoagulants (OACs) to prevent thromboembolic events. This study aimed to evaluate anticoagulation knowledge and medication adherence in AF patients on OACs at a tertiary care center in Nepal.

Patients and methods: A descriptive cross-sectional study involving patients diagnosed with AF who were prescribed OACs at the Cardiology Department of Dhulikhel Hospital, Nepal, was conducted from March to June 2024. Data were collected using questionnaires, including the Oral Anticoagulation Knowledge Tool (AKT) and the Adherence in Chronic Diseases Scale (ACDS). The study included patients from the Dhulikhel Atrial Fibrillation (DAF) Registry database along with other AF patients visiting the cardiac department. Descriptive statistics were used to summarize patient demographics, knowledge scores, and adherence levels. Inferential statistics were used to observe the associations.

Results: Among the 114 AF patients enrolled in the study, 93 were receiving OAC therapy and were interviewed. The mean age of the participants was 66.84 ± 12.3 years, with the majority being female (57%). The study revealed that a significant portion of patients lacked adequate knowledge about their OAC therapy, with only 48% having adequate knowledge as per the AKT. Additionally, 83.9% of the patients demonstrated high adherence to their medication regimen, whereas 16.1% showed medium adherence. The duration of use of OACs was found to be significantly associated with adequate anticoagulation knowledge.

Conclusion: The study findings indicate that a significant proportion of AF patients in Nepal lack adequate anticoagulation knowledge, highlighting an opportunity for improved educational interventions.