Impact of an electronic medium delivery of warfarin education in a low income, minority outpatient population: a pilot intervention study.
Aged
Ambulatory Care Facilities
Anticoagulants
/ therapeutic use
Computers, Handheld
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Minority Groups
/ education
Outpatients
/ education
Patient Education as Topic
/ methods
Patient Satisfaction
/ statistics & numerical data
Pharmacists
Pilot Projects
Poverty
/ statistics & numerical data
Program Evaluation
Surveys and Questionnaires
Videotape Recording
Warfarin
/ therapeutic use
Education
Health literacy
Primary care
Technology
Warfarin
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
05 Aug 2019
05 Aug 2019
Historique:
received:
21
01
2019
accepted:
25
07
2019
entrez:
7
8
2019
pubmed:
7
8
2019
medline:
31
10
2019
Statut:
epublish
Résumé
Warfarin is classified as a high-alert medication for ambulatory healthcare and safe guards for high-alert medications are necessary, including the practice of mandatory patient education. The high cost of hospitalizations related to adverse events combined with the average bleeding event rate of 7-8% in spite of routine patient education, suggests the importance of new approaches to standardized health education on warfarin. We sought to evaluate the impact of a warfarin educational video using an electronic tablet on patient knowledge and to determine patients' satisfaction with the use of an electronic tablet for educational purposes in outpatient clinics serving a low income, minority population. A warfarin educational video delivered on an electronic tablet (iPad) was delivered at two pharmacist-managed anticoagulation clinics to uninsured patients whose annual income is equal or less than two hundred percent below the poverty level were offered. Patients (n = 18) completed a pre-video and post-video knowledge test on warfarin before and after viewing the warfarin educational video on an electronic tablet and a follow-up test to measure the retention of knowledge and a patient satisfaction survey at 60 days. The primary outcome was change in knowledge test scores. Other outcome measures included adherence rates, adverse events, time in therapeutic INR range, and patient-reported satisfaction scores. The majority of patients were uninsured men taking warfarin for atrial fibrillation (n = 5). The median scores at post-video knowledge test and follow-up knowledge test were significantly higher than that for the pre-knowledge test (12 (11-12) vs. 10(8-11), p < 0.001). The study group had a 'time in therapeutic INR' range of 56.3%, a rate of adverse events of 24.5%, and a self-reported adherence rate to warfarin of 94.1%. The majority of patients also had positive responses to the patient satisfaction survey. Patient education delivered via iPad to facilitate knowledge of medication can serve as a useful tool for educating patients about warfarin and warfarin therapy. Use of an electronic medium may be a unique way to provide standard medication education to patients. The study was retrospectively registered with: NCT03650777 ; 9/18/18.
Sections du résumé
BACKGROUND
BACKGROUND
Warfarin is classified as a high-alert medication for ambulatory healthcare and safe guards for high-alert medications are necessary, including the practice of mandatory patient education. The high cost of hospitalizations related to adverse events combined with the average bleeding event rate of 7-8% in spite of routine patient education, suggests the importance of new approaches to standardized health education on warfarin. We sought to evaluate the impact of a warfarin educational video using an electronic tablet on patient knowledge and to determine patients' satisfaction with the use of an electronic tablet for educational purposes in outpatient clinics serving a low income, minority population.
METHODS
METHODS
A warfarin educational video delivered on an electronic tablet (iPad) was delivered at two pharmacist-managed anticoagulation clinics to uninsured patients whose annual income is equal or less than two hundred percent below the poverty level were offered. Patients (n = 18) completed a pre-video and post-video knowledge test on warfarin before and after viewing the warfarin educational video on an electronic tablet and a follow-up test to measure the retention of knowledge and a patient satisfaction survey at 60 days. The primary outcome was change in knowledge test scores. Other outcome measures included adherence rates, adverse events, time in therapeutic INR range, and patient-reported satisfaction scores.
RESULTS
RESULTS
The majority of patients were uninsured men taking warfarin for atrial fibrillation (n = 5). The median scores at post-video knowledge test and follow-up knowledge test were significantly higher than that for the pre-knowledge test (12 (11-12) vs. 10(8-11), p < 0.001). The study group had a 'time in therapeutic INR' range of 56.3%, a rate of adverse events of 24.5%, and a self-reported adherence rate to warfarin of 94.1%. The majority of patients also had positive responses to the patient satisfaction survey.
CONCLUSIONS
CONCLUSIONS
Patient education delivered via iPad to facilitate knowledge of medication can serve as a useful tool for educating patients about warfarin and warfarin therapy. Use of an electronic medium may be a unique way to provide standard medication education to patients.
TRIAL REGISTRATION
BACKGROUND
The study was retrospectively registered with: NCT03650777 ; 9/18/18.
Identifiants
pubmed: 31382942
doi: 10.1186/s12889-019-7370-4
pii: 10.1186/s12889-019-7370-4
pmc: PMC6683532
doi:
Substances chimiques
Anticoagulants
0
Warfarin
5Q7ZVV76EI
Banques de données
ClinicalTrials.gov
['NCT03650777']
Types de publication
Clinical Trial
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1050Références
Health Aff (Millwood). 2003 Jul-Aug;22(4):147-53
pubmed: 12889762
Br J Haematol. 2005 Apr;129(1):72-8
pubmed: 15801958
Ann Pharmacother. 2006 Apr;40(4):633-8
pubmed: 16551766
Health Educ Behav. 2006 Jun;33(3):352-73
pubmed: 16699125
Res Social Adm Pharm. 2005 Mar;1(1):40-59
pubmed: 17138465
Arch Intern Med. 2007 Feb 12;167(3):239-45
pubmed: 17296878
BMC Health Serv Res. 2008 Feb 14;8:40
pubmed: 18275605
Int J Psychiatry Med. 2009;39(2):113-32
pubmed: 19860071
Pharmacoepidemiol Drug Saf. 2010 Jul;19(7):731-6
pubmed: 20583203
Prim Health Care Res Dev. 2012 Jan;13(1):42-7
pubmed: 21854695
J Prim Care Community Health. 2012 Jan 1;3(1):65-74
pubmed: 23804857
PLoS One. 2013 Sep 09;8(9):e74037
pubmed: 24040156
J Patient Saf. 2015 Sep;11(3):160-5
pubmed: 24522209
Genome Med. 2014 Feb 26;6(2):16
pubmed: 24571651
BMC Res Notes. 2015 Sep 10;8:429
pubmed: 26358332
Transl Behav Med. 2015 Dec;5(4):470-82
pubmed: 26622919
BMC Public Health. 2018 May 22;18(1):646
pubmed: 29788998
Thromb Haemost. 1993 Mar 1;69(3):236-9
pubmed: 8470047