PATIETS GUIDE: EFFECT ON THEIR KNOWLEDGE AND BEHAVIOR TOWARD WARFARIN-VITAMIN K NUTRIENT-DRUG INTERACTION PART TWO

Abstract

Thromboembolic disease is a common medical condition which, if untreated, carries a significant risk of morbidity and mortality. Treatment with anticoagulant therapy, while clearly beneficial, may expose patients to potentially serious side effects. The aim of the study: This study aimed to 1. Assess patients' knowledge of nutrient and drug interactions with oral anticoagulant therapy (warfarin) 2. Assess the effect of the nutrient-drug interactions on patients receiving oral anticoagulant therapy (warfarin) through assessing their PT/INR. 3. Evaluate the effect of patients' compliance towards guidelines for management of food/drug interaction with oral anticoagulant therapy (warfarin) on patients' PT/INR. Research methodology: An exploratory experimental design was used in the conduction of this study at the cardiothoracic surgery outpatient clinic for follow up at Ain Shams University Hospital. This study involved 30 patients attending the clinic for follow up and they were receiving oral anticoagulant therapy for more than one month and were randomly selected. Data collection tools included a structured interview questionnaire sheet for patients, 24 hours recall sheet and Vit K intake assessment card, PT and INR flow sheet, a booklet containing an instructional program, and patient's opinionnaire sheet. Consent was obtained then data were collected through 3 phases: the pre-assessment phase, implementation phase, and the evaluation phase. Then the data were statistically analyzed & tabulated. Results: There was a significant difference between patients’ knowledge before and after the program regarding food, precautions, and complications. 80% of the study sample kept the suitable amount of food containing vitamin K in follow up phase 1 and 2 post-program but the percent decreased in phase 3 to reach 56.6%. There was no significant difference between the assessments of 24-hour recall of food in the three follow up phases. No significant differences in PT/INR between the 3 follow up phases. Conclusions: There was an improvement in the patients' knowledge regarding food, precautions, and complications. Patients' compliance appeared in the result of phases 1 and 2 post-program while their compliance decreased in the 3rd follow up test analysis.