Use and assessment of knowledge of Vitamin K antagonist therapy in cardiac patients: A Tertiary Care Hospital-based survey

Abstract

Background: Safety and efficacy of Vitamin K antagonists (VKAs), the most widely used oral anticoagulant (OAC), is monitored by therapeutic international normalized ratio (INR). The current study was conducted to evaluate the proportion of patients achieving therapeutic range INR and assessment of the knowledge, and awareness among patients regarding OAC therapy, as well as identification of the challenges in the monitoring of INR. Materials and Methods: This hospital-based, single-center cross-sectional study was conducted at a tertiary care hospital in Delhi. Patients on anticoagulation with VKAs were interviewed and their records were reviewed. Information on sociodemographic characteristics, history of cardiac illness, INR range, knowledge, and awareness regarding VKA therapy were analyzed. Data management was done via CSPro and statistical analysis via STATA 13.0. Results: A total of 86 patients were evaluated. The mean age of the study participants was 49 ± 14.9 years. Only 29.1% of the study group achieved therapeutic INR. Overall awareness and knowledge regarding the need for VKA therapy, ideal INR range, complications of poor monitoring, and dietary restrictions were in the range of 31%–48%. Conclusion: Poor INR control is prevalent in Indian patients on VKAs therapy. Although the future practice may move toward newer anticoagulants, a substantial proportion of our population may still need VKAs. Hence, there is a need for improving the knowledge and awareness of patients on VKA therapy to improve therapeutic effectiveness.

Keywords

• atrial fibrillation
• mechanical prosthetic heart valve
• newer oral anticoagulants
• oral anticoagulant
• therapeutic international normalized ratio