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PATIENTS' KNOWLEDGE OF ATRIAL FIBRILLATION AND WARFARIN: ADHERENCE AND COMPLIANCE TO WARFARIN AND FREQUENCY DISTRIBUTION OF INTERNATIONAL NORMALIZED RATIO VALUES DURING WARFARIN TAKING
October 2009, Vol 136, No. 4_MeetingAbstracts Abstract: Poster Presentations | October 2009
PATIENTS’ KNOWLEDGE OF ATRIAL FIBRILLATION AND WARFARIN: ADHERENCE AND COMPLIANCE TO WARFARIN AND FREQUENCY DISTRIBUTION OF INTERNATIONAL NORMALIZED RATIO VALUES DURING WARFARIN TAKING Nobuyuki Anzai, MD*; Hiroko Anzai, MD; Rieko Mitobe, MD; Makiko Anzai, MD; Sadako Furuya, MD Anzai-Furuya Clinic, Oyama, Japan Chest Chest. 2009;136(4_MeetingAbstracts):99S. doi:10.1378/chest.136.4_MeetingAbstracts.99S-a Abstract PURPOSE: Little has been known about patients’ knowledge of atrial fibrillation(af), stroke and warfarin, and frequency distribution of international normalized ratio values (INR) during warfarin taking. METHODS: Ninety one patients, with mean follow-up duration of 44 (SD23) months, 330 patient year, 0.9 monitoring test/month, were investigated. Patients were interviewed using open ended and prompted questions on af, stroke and warfarin. 1887 INR, between january 2007 and december 2008, were studied. RESULTS: Patients’ average age: 73 (SD 8), female: 27 (30%), high school or higher education: 68 (75%). Af was diagnosed, 49 (44%) by subjective symptoms, 23 (25%) incidentally, 20 (22%) by medical checkup and 8 (9%) by onset of stroke. Only 30% knew cardiac performance of af. 64% knew af symptoms or sings > 1. 62% knew stroke is potential complication of af. 30% did not know symptoms of stroke > 1. 52% did not know aim of warfarin monitoring test. Age made signinicant difference in knowledge of monitoring test(P = 0.001). 82% knew adjusted warfarin doses. 69% knew monitored INR. 95% had regular monitoring test 96% took warfarin as prescribed doses. 96% had regular and daily warfarin taking. 90% knew diet (especially natto) influencing on warfarin effect. 90% did not take vitamin K rich food. 78% paid attention to take medicine and dietary supplements. INR were categorized into six groups. Maximum(max) INR and frequencies of INR in each group were as follows: INR < 1.5:max INR: 1.4(SD 0.8), frequency: 108 (5.7%), 1.5≦INR < 2.0: max INR: 1.9 (SD 0.3) frequency: 615 (32.5%), 2.0≦INR < 2.5:2.4 (SD 0.6), 708 (37.5%), 2.5≦INR < 3.0:2.8
(SD 0.2), 327(17.3%), 3.0≦INR < 4.0:4.3 (SD 0.2), 92(4.9%), 4.0≦INR:4.3 (SD 0.3), 9(0.5%). Age made signinificant difference in INR < 1.5 (P = 0.001) and 3.0≦INR (P = 0.01). 43.6% of INR were out of 2.0–3.0. The questionnaire on knowledge of af score revealing 51% of patients diagnosed incidentally and by medical checkup had little knowledge of af,stroke and warfarin. CONCLUSION: Af patients need more knowledge on af and warfarin. Elderly patients may need closer INR monitoring. CLINICAL IMPLICATIONS: The results can be useful to further education for closer monitoring to elderly patients. DISCLOSURE: Nobuyuki Anzai, No Financial Disclosure Information; No Product/Research Disclosure Information Wednesday, November 4, 2009 12:45 PM - 2:00 PM
PATIENTS’ KNOWLEDGE OF ATRIAL FIBRILLATION AND WARFARIN: ADHERENCE AND COMPLIANCE TO WARFARIN AND FREQUENCY DISTRIBUTION OF INTERNATIONAL NORMALIZED RATIO VALUES DURING WARFARIN TAKING Nobuyuki Anzai, MD*; Hiroko Anzai, MD; Rieko Mitobe, MD; Makiko Anzai, MD; Sadako Furuya, MD Anzai-Furuya Clinic, Oyama, Japan Chest Chest. 2009;136(4_MeetingAbstracts):99S. doi:10.1378/chest.136.4_MeetingAbstracts.99S-a Abstract PURPOSE: Little has been known about patients’ knowledge of atrial fibrillation(af), stroke and warfarin, and frequency distribution of international normalized ratio values (INR) during warfarin taking. METHODS: Ninety one patients, with mean follow-up duration of 44 (SD23) months, 330 patient year, 0.9 monitoring test/month, were investigated. Patients were interviewed using open ended and prompted questions on af, stroke and warfarin. 1887 INR, between january 2007 and december 2008, were studied. RESULTS: Patients’ average age: 73 (SD 8), female: 27 (30%), high school or higher education: 68 (75%). Af was diagnosed, 49 (44%) by subjective symptoms, 23 (25%) incidentally, 20 (22%) by medical checkup and 8 (9%) by onset of stroke. Only 30% knew cardiac performance of af. 64% knew af symptoms or sings > 1. 62% knew stroke is potential complication of af. 30% did not know symptoms of stroke > 1. 52% did not know aim of warfarin monitoring test. Age made signinicant difference in knowledge of monitoring test(P = 0.001). 82% knew adjusted warfarin doses. 69% knew monitored INR. 95% had regular monitoring test 96% took warfarin as prescribed doses. 96% had regular and daily warfarin taking. 90% knew diet (especially natto) influencing on warfarin effect. 90% did not take vitamin K rich food. 78% paid attention to take medicine and dietary supplements. INR were categorized into six groups. Maximum(max) INR and frequencies of INR in each group were as follows: INR < 1.5:max INR: 1.4(SD 0.8), frequency: 108 (5.7%), 1.5≦INR < 2.0: max INR: 1.9 (SD 0.3) frequency: 615 (32.5%), 2.0≦INR < 2.5:2.4 (SD 0.6), 708 (37.5%), 2.5≦INR < 3.0:2.8
(SD 0.2), 327(17.3%), 3.0≦INR < 4.0:4.3 (SD 0.2), 92(4.9%), 4.0≦INR:4.3 (SD 0.3), 9(0.5%). Age made signinificant difference in INR < 1.5 (P = 0.001) and 3.0≦INR (P = 0.01). 43.6% of INR were out of 2.0–3.0. The questionnaire on knowledge of af score revealing 51% of patients diagnosed incidentally and by medical checkup had little knowledge of af,stroke and warfarin. CONCLUSION: Af patients need more knowledge on af and warfarin. Elderly patients may need closer INR monitoring. CLINICAL IMPLICATIONS: The results can be useful to further education for closer monitoring to elderly patients. DISCLOSURE: Nobuyuki Anzai, No Financial Disclosure Information; No Product/Research Disclosure Information Wednesday, November 4, 2009 12:45 PM - 2:00 PM