OBJECTIVES:

Despite 60 years of clinical experience, achieving and maintaining stable International Normalized Ratio (INR) in patients using vitamin k antagonists (VKA) remains a difficult task. We therefore aimed to understand Disparities in Perceptions, Attitude, and Practise on Clinical Outcomes of Patients Taking Vitamin K Antagonists.

METHODS:

Single centre, prospective, cross-sectional study was conducted among patients taking VKAs enrolled in Anticoagulation clinic (ACC) for a period of one year. A validated 32 item tool with four domains (Perceptions:12, Attitude: 8, Practice: 8 & Satisfaction – 4 items) was administered to study population by face-to-face interview by a clinical pharmacist after obtaining consent. Clinical outcomes such as stroke, systemic embolic events, and bleeding were examined. Where appropriate, IBM SPSS version 25.0 was used to run descriptive and inferential statistics.

RESULTS:

Among 138 patients, 74 (53.62%) of patients were male, 64 (46.37%) of patients were female and 30(21.73%) of patients were around the age group of 51-70 years. Majority 88 (63.76%) of the patients receiving life time VKAs for Mitral value replacement 36 (26.08%), Atrial fibrillation 34 (24.6%), artificial value replacement 18 (13.04%). Majority 49 (35.50%) of patients had both diabetes and hypertension. Patients with poor anticoagulation control 54 (39.1%) had [indefinite perceptions 42 (77.63%), negative attitude 47 (87.03%), poor practice 51 (94.45%) and fairly satisfied 45 (83.34%) (p<0.001)]. Major bleeding and thromboembolic events (1.8% and 2.4%, p>0.001) were low in the overall study population.

CONCLUSIONS: The overall perceptions, attitudes, practise, and satisfaction of our study population with poor anticoagulation control differed, emphasising the need for structured patient tailored interventions by a collaborative multidisciplinary approach to VKA anticoagulation care by physicians and clinical pharmacists.