Nine years' experience of an educational programme for patients treated with oral anticoagulants in a cardiology department.

Abstract

Objectives: Oral anticoagulants present significant risks of iatrogenic complications. An educational programme dedicated to patients treated with vitamin-K antagonists (VKAs) or direct oral anticoagulants (DOACs) was set up in our cardiology department in 2013. The aim of this study is to describe and assess our programme's effectiveness, through evaluation of patients' skills and adherence, and to identify associated factors.

Methods: Skills were assessed through a questionnaire designed by our multidisciplinary team, targeting different items, and a global score was rated from 0 to 1. Adherence was assessed using a validated tool. Data from patients educated between January 2013 and December 2021 were collected retrospectively. R software was used for statistical analysis, performing Student or χ² tests for comparison of variables and univariate linear regression analysis for identification of variability factors. A value of p<0.05 was considered significant.

Results: Since 2013, 934 patients were educated, representing 14.7% of patients with oral anticoagulants in cardiology units. Mean±SD age was 68.7±16.4 years and the proportion of men was 58.9%. After hospital discharge, skills were assessed for 334 patients: mean score was 0.80±0.17 (minimum 0.1 to maximum 1). Younger patients presented higher scores than older ones (p<0.001). Adherence was assessed for 331 patients: levels were high, medium and low for 58%, 31.4% and 10.6% of them, respectively. Women presented higher adherence than men (p=0.01). Neither oral anticoagulant type (VKA or DOAC) nor characteristics of educational sessions presented significant association with skills or adherence.

Conclusions: Our programme educated a large number of patients and seems to fit with VKAs and DOACs. Improvement areas could be to increase patient assessment and to reinforce education of elderly patients.