Effectiveness of nursing strategies to promote therapeutic adherence to vitamin K antagonists: A systematic review

IF 1.2 Q3 NURSING

Journal of Vascular Nursing Pub Date : 2025-07-28 DOI:10.1016/j.jvn.2025.07.003

Matheus Vinicius Barbosa da Silva, Natannael da Silva Pereira, Xênia Sheila Barbosa Aguiar Queiroz, Maria Mariana Barros Melo da Silveira, Simone Maria Muniz da Silva Bezerra

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引用次数: 0

Abstract

Background

The incorporation of anticoagulant therapies into clinical practice has played a crucial role in reducing and preventing venous thromboembolic, cerebrovascular, and cardiopulmonary events, as well as their subsequent adverse outcomes in patients with prothrombotic conditions. Furthermore, the need for regular monitoring to maintain adequate anticoagulation levels presents a challenge in the use of vitamin K antagonists (VKAs). This study aimed to evaluate the effectiveness of strategies developed by nurses to promote therapeutic adherence to VKAs.

Methods

A comprehensive systematic review was conducted using the LILACS, BDENF, MEDLINE, ScienceDirect, and CINAHL databases. Study selection and sampling in the electronic databases were assisted by the Rayyan software. The review protocol was registered in the PROSPERO database (identifier CRD42024545808), and the report followed PRISMA guidelines.

Results

Evidence indicates that nurse-led interventions increase patients knowledge about the therapy, improve adherence to treatment and INR monitoring, extend the time within the therapeutic range, and reduce the risk of adverse outcomes related to the therapy.

Conclusion

Although more robust studies, such as multicenter randomized clinical trials, are needed, current evidence suggests that nurse-led interventions are effective and safe in promoting therapeutic adherence.

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促进维生素K拮抗剂治疗依从性的护理策略的有效性：一项系统综述

背景：在临床实践中，抗凝治疗在减少和预防静脉血栓栓塞、脑血管和心肺事件及其随后的不良后果方面发挥了至关重要的作用。此外，需要定期监测以维持足够的抗凝水平，这对使用维生素K拮抗剂（vka）提出了挑战。本研究旨在评估护士制定的策略的有效性，以促进对vka的治疗依从性。方法采用LILACS、BDENF、MEDLINE、ScienceDirect和CINAHL数据库进行综合系统评价。电子数据库中的研究选择和抽样由Rayyan软件辅助。审查方案已在PROSPERO数据库中注册（标识符CRD42024545808），报告遵循PRISMA指南。结果有证据表明，护士主导的干预措施增加了患者对治疗的认识，提高了治疗依从性和INR监测，延长了治疗范围内的时间，降低了治疗相关不良后果的风险。结论：虽然还需要更多强有力的研究，如多中心随机临床试验，但目前的证据表明，护士主导的干预措施在促进治疗依从性方面是有效和安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Vascular Nursing NURSING-

CiteScore

1.40

自引率

0.00%

发文量

期刊介绍： Journal of Vascular Nursing provides clinical information regarding aortic and peripheral aneurysms, upper and lower extremity arterial disease, acute and chronic venous disease, and more. Original, peer-reviewed articles present descriptions, etiologies, diagnostic procedures, medical and surgical treatment and nursing implications of vascular system disorders.