| Title |
Predictive factors for obtaining a correct therapeutic range using antivitamin K anticoagulants: a tertiary center experience of patient adherence to anticoagulant therapy
|
|---|---|
| Published in |
Patient preference and adherence, September 2015
|
| DOI | 10.2147/ppa.s87066 |
| Pubmed ID | |
| Authors |
Ruxandra Jurcuţ, Sebastian Militaru, Oliviana Geavlete, Nic Drăgotoiu, Sergiu Sipoş, Răzvan Roşulescu, Carmen Ginghină, Ciprian Jurcuţ |
| Abstract |
Patient adherence is an essential factor in obtaining efficient oral anticoagulation using vitamin K antagonists (VKAs), a situation with a narrow therapeutic window. Therefore, patient education and awareness are crucial for good management. Auditing the current situation would help to identify the magnitude of the problem and to build tailored education programs for these patients. This study included 68 hospitalized chronically anticoagulated patients (mean age 62.6±13.1 years; males, 46%) who responded to a 26-item questionnaire to assess their knowledge on VKA therapy management. Laboratory and clinical data were used to determine the international normalized ratio (INR) at admission, as well as to calculate CHA2DS2-VASC and HAS-BLED scores for patients with atrial fibrillation. The majority of patients (62%) were receiving VKA for atrial fibrillation, the others for a mechanical prosthesis and previous thromboembolic disease or stroke. In the atrial fibrillation group, the mean CHA2DS2-VASC score was 3.1±1.5, while the average HAS-BLED score was 1.8±1.2. More than half of the patients (53%) had an INR outside of the therapeutic range at admission, with the majority (43%) having a low INR. A correct INR value was predicted by education level (higher education) and the diagnostic indication (patients with mechanical prosthesis being best managed). Patients presenting with a therapeutic INR had a trend toward longer treatment duration than those outside the therapeutic range (62±72 months versus 36±35 months, respectively, P=0.06). There was no correlation between INR at admission and the patient's living conditions, INR monitoring frequency, and bleeding history. In a tertiary cardiology center, more than half of patients receiving VKAs are admitted with an INR falling outside the therapeutic range, irrespective of the bleeding or embolic risk. Patients with a mechanical prosthesis and complex antithrombotic regimens appear to be the most careful with INR monitoring, especially if they have a higher level of education. Identifying patient groups with the lowest time interval spent in the therapeutic range could help attending physicians educate patients focusing on specific awareness issues. |
X Demographics
The data shown below were collected from the profiles of 2 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 42 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 42 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 7 | 17% |
| Researcher | 7 | 17% |
| Student > Ph. D. Student | 6 | 14% |
| Student > Bachelor | 4 | 10% |
| Student > Postgraduate | 3 | 7% |
| Other | 9 | 21% |
| Unknown | 6 | 14% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 15 | 36% |
| Pharmacology, Toxicology and Pharmaceutical Science | 3 | 7% |
| Nursing and Health Professions | 3 | 7% |
| Arts and Humanities | 2 | 5% |
| Agricultural and Biological Sciences | 2 | 5% |
| Other | 7 | 17% |
| Unknown | 10 | 24% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 09 September 2015.
All research outputs
#18,171,970
of 23,342,232 outputs
Outputs from Patient preference and adherence
#1,204
of 1,635 outputs
Outputs of similar age
#181,596
of 267,946 outputs
Outputs of similar age from Patient preference and adherence
#42
of 46 outputs
Altmetric has tracked 23,342,232 research outputs across all sources so far. This one is in the 19th percentile – i.e., 19% of other outputs scored the same or lower than it.
So far Altmetric has tracked 1,635 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.7. This one is in the 18th percentile – i.e., 18% of its peers scored the same or lower than it.
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We're also able to compare this research output to 46 others from the same source and published within six weeks on either side of this one. This one is in the 2nd percentile – i.e., 2% of its contemporaries scored the same or lower than it.