Impact of an educational intervention on the safety of geriatric patients with atrial fibrillation in use of warfarin
Objective: To identify contributions of an educational intervention on the knowledge of geriatric patients about safety aspects of treatment with warfarin. Methods: A longitudinal intervention study conducted in an anticoagulation clinic of a public university hospital located in Minas Gerais, carried out with geriatric patients who had a diagnosis of valvular or non-valvular atrial fibrillation in use of warfarin. The participants answered a questionnaire on general knowledge about the anticoagulant therapy with warfarin, validated in Brazil (OAK test) and analyzed by a committee of specialist judges to select the questions about safety of this instrument in the present study. Afterwards, the patients participated in an educational intervention centered on the patient and on self-care; the outcome analyzed was the test score of knowledge about anticoagulation before (T0), immediately after (T1) and six months after (T2) the intervention. The data were descriptively analyzed using absolute and relative frequencies. The data were descriptively analyzed using absolute and relative frequencies. Results: The participants of this study were 43 patients with a mean age of 71±7.6 years old, predominance of females with 25 (58.1%), and mean schooling of 5±4.8 years. Questions 1, 2, 3, 4, 5, 6, 9, 12, 13, 15, 17, 19 and 20 analyzed by the judges had a CVI assessed at 1.0, questions 7, 10, 16 and 18 had a CVI assessed at 0.92, and questions 8 and 14 had CVI values below 0.78 and were rated at 0.75 and 0.58 respectively, thus being excluded from the study. For most of the questions, an improvement in the patients’ knowledge about treatment safety was identified after the educational intervention (p<0.05). The questions for which no increase in knowledge was identified were related to when to seek medical care in emergency situations and to the risks of bleeding. Conclusion: Offering the educational intervention improved the participants’ knowledge about the safety of the anticoagulant treatment, considering the OAK test questions that presented CVI values > 0.75, according to the judges’ evaluation.
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