ASSESSING THE IMPACT OF INCORPORATING PATIENT KNOWLEDGE AND BELIEFS INTO ANTICOAGULATION THERAPY MANAGEMENT SERVICES

Author(s)

Danielle Chauncey Lavallee, PharmD, PhD, Director, Center for Medication Use and Outcomes Research1, C. Daniel Mullins, PhD, Professor and Chair1, Stuart Tilman Haines, PharmD, FASHP, Professor1, Francoise G. Pradel, PhD, Associate Professor1, Francis B. Palumbo, PhD, JD, Professor1, Anthony C. Tommasello, PhD, Associate Professor1, Reed A. Winston, MD, PhD, Physician21University of Maryland School of Pharmacy, Baltimore, MD, USA; 2 Bon Secours Baltimore Health System, Baltimore, MD, USA

Objective: The primary aim was to determine the impact on INR control resulting from the integration of information on patient health literacy and numeracy, health knowledge and health beliefs regarding warfarin therapy into the clinical information provided to the pharmacist. Methods: A single-blinded randomized controlled study was conducted to test the hypothesis that including information on patient's health literacy, numeracy, and anticoagulation knowledge and beliefs improves patient INR control. Patients were recruited from anticoagulation management services at the University of Maryland Medical Center and the Baltimore VA Medical Center. Enrolled patients completed a series of questionnaires assessing individual anticoagulation knowledge and beliefs, literacy and numeracy skills. Only patients in the intervention arm had the information incorporated into the clinical chart used by the pharmacist to manage warfarin therapy. Results: A total of 160 patients consented and were randomized into the study, representing a 69.2% enrollment rate. Variation in INR readings did not improve as a result of the inclusion of patient information sheets in the charts of the intervention group as compared to patients receiving standard of care (difference=0.037; p=0.58). Patient knowledge of anticoagulation therapy significantly improved in the intervention group as compared to patients receiving standard of care (difference=0.8 points (measured on a 20-point scale); p=0.04). Conclusion: Systematic inclusion of information regarding patient knowledge and beliefs of oral anticoagulation therapy, literacy and numeracy skills did not improve INR control but improved patient knowledge of anticoagulation therapy. While patient knowledge can be improved by providing opportunities to individualize educational interventions, further studies are needed to identify effective interventions to improve INR control and patient outcomes.

Conference/Value in Health Info

2008-05, ISPOR 2008, Toronto, Ontario, Canada

Value in Health, Vol. 11, No. 3 (May/June 2008)

Code

PCV81

Topic

Health Service Delivery & Process of Care, Organizational Practices

Topic Subcategory

Academic & Educational, Quality of Care Measurement, Treatment Patterns and Guidelines

Disease

Cardiovascular Disorders

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