open access

Vol 76, No 7 (2018)
Original articles
Published online: 2018-03-07
Submitted: 2018-02-07
Accepted: 2018-03-06
Get Citation

Differences in knowledge among patients with atrial fibrillation receiving non-vitamin K antagonist oral anticoagulants and vitamin K antagonists

Małgorzata Konieczyńska, Ewa Sobieraj, Agata H. Bryk, Maciej Dębski, Maciej Polak, Piotr Podolec, Barbara Małecka, Andrzej Pająk, Lien Desteghe, Hein Heidbuchel, Anetta Undas
DOI: 10.5603/KP.a2018.0069
·
Pubmed: 29528483
·
Kardiol Pol 2018;76(7):1089-1096.

open access

Vol 76, No 7 (2018)
Original articles
Published online: 2018-03-07
Submitted: 2018-02-07
Accepted: 2018-03-06

Abstract

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used for stroke prevention in patients with atrial fibrillation (AF) worldwide. Few articles have compared current understanding of AF patients about the disease and anticoagulant therapy in relation to the medications used.

Aim: We sought to compare the knowledge of AF and anticoagulation between AF patients treated with NOACs and those on vitamin K antagonists (VKAs).

Methods: We used the Jessa AF Knowledge Questionnaire (JAKQ), developed and validated in Belgium. Patients were re­cruited at a tertiary centre in Kraków, Poland.

Results: A total of 479 AF patients completed the JAKQ. Patients on NOACs (n = 276, 57.6%) compared with those on VKAs (n = 175, 36.5%) did not differ regarding demographic and clinical variables. The mean score of the JAKQ was very similar in the NOAC and VKA group (60.7 ± 17.0% vs. 61.6 ± 17.1%; p = 0.4, respectively). The differences in the proportion of correct responses referred to three questions. Consequences of AF, such as blood clots and cerebral infarction, were more obvious for patients on NOACs compared with those on VKAs (81.5% vs. 70.9%; p = 0.01). The patients on NOACs (78.7% vs. 67.6%; p = 0.009) more frequently considered consulting a physician for advice concerning anticoagulant treatment before surgery, while fewer patients on NOACs were aware of the need to take their medication even if they did not feel AF (76.1% vs. 89.7%; p = 0.0004). Only 25.9% of the VKA patients and 49.3% of the NOAC users knew what to do if they missed a dose of the anticoagulant.

Conclusions: The knowledge of arrhythmia and anticoagulation is better regarding the safety issues among subjects on NOACs compared with those on VKAs. Irrespective of the type of oral anticoagulation therapy, education of AF patients should be improved.

Abstract

Background: Non-vitamin K antagonist oral anticoagulants (NOACs) are increasingly used for stroke prevention in patients with atrial fibrillation (AF) worldwide. Few articles have compared current understanding of AF patients about the disease and anticoagulant therapy in relation to the medications used.

Aim: We sought to compare the knowledge of AF and anticoagulation between AF patients treated with NOACs and those on vitamin K antagonists (VKAs).

Methods: We used the Jessa AF Knowledge Questionnaire (JAKQ), developed and validated in Belgium. Patients were re­cruited at a tertiary centre in Kraków, Poland.

Results: A total of 479 AF patients completed the JAKQ. Patients on NOACs (n = 276, 57.6%) compared with those on VKAs (n = 175, 36.5%) did not differ regarding demographic and clinical variables. The mean score of the JAKQ was very similar in the NOAC and VKA group (60.7 ± 17.0% vs. 61.6 ± 17.1%; p = 0.4, respectively). The differences in the proportion of correct responses referred to three questions. Consequences of AF, such as blood clots and cerebral infarction, were more obvious for patients on NOACs compared with those on VKAs (81.5% vs. 70.9%; p = 0.01). The patients on NOACs (78.7% vs. 67.6%; p = 0.009) more frequently considered consulting a physician for advice concerning anticoagulant treatment before surgery, while fewer patients on NOACs were aware of the need to take their medication even if they did not feel AF (76.1% vs. 89.7%; p = 0.0004). Only 25.9% of the VKA patients and 49.3% of the NOAC users knew what to do if they missed a dose of the anticoagulant.

Conclusions: The knowledge of arrhythmia and anticoagulation is better regarding the safety issues among subjects on NOACs compared with those on VKAs. Irrespective of the type of oral anticoagulation therapy, education of AF patients should be improved.

Get Citation

Keywords

atrial fibrillation, non-vitamin K antagonist oral anticoagulants, vitamin K antagonists, questionnaire

Supplementary Files (1)
Supplemental tables
Download
27KB
About this article
Title

Differences in knowledge among patients with atrial fibrillation receiving non-vitamin K antagonist oral anticoagulants and vitamin K antagonists

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Vol 76, No 7 (2018)

Pages

1089-1096

Published online

2018-03-07

DOI

10.5603/KP.a2018.0069

Pubmed

29528483

Bibliographic record

Kardiol Pol 2018;76(7):1089-1096.

Keywords

atrial fibrillation
non-vitamin K antagonist oral anticoagulants
vitamin K antagonists
questionnaire

Authors

Małgorzata Konieczyńska
Ewa Sobieraj
Agata H. Bryk
Maciej Dębski
Maciej Polak
Piotr Podolec
Barbara Małecka
Andrzej Pająk
Lien Desteghe
Hein Heidbuchel
Anetta Undas

References (18)
  1. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016; 37(38): 2893–2962.
  2. Undas A, Pasierski T, Windyga J, et al. Practical aspects of new oral anticoagulant use in atrial fibrillation. Pol Arch Med Wewn. 2014; 124(3): 124–135.
  3. Lane DA, Aguinaga L, Blomström-Lundqvist C, et al. Cardiac tachyarrhythmias and patient values and preferences for their management: the European Heart Rhythm Association (EHRA) consensus document endorsed by the Heart Rhythm Society (HRS), Asia Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulación Cardíaca y Electrofisiología (SOLEACE). Europace. 2015; 17(12): 1747–1769.
  4. Heidbuchel H, Verhamme P, Alings M, et al. Updated European Heart Rhythm Association practical guide on the use of non-vitamin-K antagonist anticoagulants in patients with non-valvular atrial fibrillation: Executive summary. Eur Heart J. 2017; 38(27): 2137–2149.
  5. Smith DE, Xuereb CB, Pattison HM, et al. TRial of an Educational intervention on patients' knowledge of Atrial fibrillation and anticoagulant therapy, INR control, and outcome of Treatment with warfarin (TREAT). BMC Cardiovasc Disord. 2010; 10: 21.
  6. Lane DA, Ponsford J, Shelley A, et al. Patient knowledge and perceptions of atrial fibrillation and anticoagulant therapy: effects of an educational intervention programme. The West Birmingham Atrial Fibrillation Project. Int J Cardiol. 2006; 110(3): 354–358.
  7. Clarkesmith D, Pattison H, Lip G, et al. Educational Intervention Improves Anticoagulation Control in Atrial Fibrillation Patients: The TREAT Randomised Trial. PLoS ONE. 2013; 8(9): e74037.
  8. Desteghe L, Engelhard L, Raymaekers Z, et al. Knowledge gaps in patients with atrial fibrillation revealed by a new validated knowledge questionnaire. Int J Cardiol. 2016; 223: 906–914.
  9. Schulman S, Kearon C. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost. 2005; 3(4): 692–694.
  10. McCabe PJ, Schad S, Hampton A, et al. Knowledge and self-management behaviors of patients with recently detected atrial fibrillation. Heart Lung. 2008; 37(2): 79–90.
  11. Lip G, Kamath S, Jafri M, et al. Ethnic differences in patient perceptions of atrial fibrillation and anticoagulation therapy: the West Birmingham Atrial Fibrillation Project. Stroke. 2002; 33(1): 238–242.
  12. Amara W, Larsen TB, Sciaraffia E, et al. Patients' attitude and knowledge about oral anticoagulation therapy: results of a self-assessment survey in patients with atrial fibrillation conducted by the European Heart Rhythm Association. Europace. 2016; 18(1): 151–155.
  13. Madrid AH, Potpara TS, Dagres N, et al. Differences in attitude, education, and knowledge about oral anticoagulation therapy among patients with atrial fibrillation in Europe: result of a self-assessment patient survey conducted by the European Heart Rhythm Association. Europace. 2016; 18(3): 463–467.
  14. Altay S, Yıldırımtürk Ö, Çakmak HA, et al. NOAC-TURK Study Collaborators. New oral anticoagulants-TURKey (NOAC-TURK): Multicenter cross-sectional study. Anatol J Cardiol. 2017; 17(5): 353–361.
  15. Connolly SJ, Ezekowitz MD, Yusuf S, et al. RE-LY Steering Committee and Investigators. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009; 361(12): 1139–1151.
  16. Patel MR, Mahaffey KW, Garg J, et al. ROCKET AF Investigators. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011; 365(10): 883–891.
  17. Granger CB, Alexander JH, McMurray JJV, et al. ARISTOTLE Committees and Investigators. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011; 365(11): 981–992.
  18. Undas A. Long-term anticoagulation in questions and answers. Pol Arch Med Wewn. 2016; 126(12): 1036–1039.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., Świętokrzyska 73 street, 80–180 Gdańsk, Poland

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail: viamedica@viamedica.pl