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Patient satisfaction with extended-interval warfarin monitoring
- Source :
- Journal of thrombosis and thrombolysis. 42(4)
- Publication Year :
- 2016
-
Abstract
- Extended-interval monitoring of warfarin has been proposed to reduce follow-up burden and improve patient satisfaction. We aimed to make an initial assessment of anticoagulation satisfaction before and after an extended-interval warfarin monitoring intervention. We conducted a translational prospective single-arm pilot study of extended-interval warfarin monitoring in five pharmacist-managed anticoagulation clinics. Patients meeting CHEST guideline criteria for extended-interval warfarin monitoring began progressive extended-interval follow-up (6, 8, and 12 weeks thereafter). The Duke Anticoagulation Satisfaction Scale (DASS) was administered at baseline and at end-of-study or study removal (in patients no longer appropriate for extended interval follow-up). Forty-six patients had evaluable pre- and post-intervention DASS survey data. Mean age of patients was 66.5 years, 74 % were non-Hispanic whites, and 48 % were men. Patients completed a mean ± SD of 34 ± 22 weeks of follow-up. Mean ± SD total DASS score at baseline was 45.2 ± 14.2 versus 49.1 ± 14.9 at end-of-study (mean change, +3.9 [95 % CI −0.6–8.4; p = 0.09]), indicating no benefit—and trending toward decrement—to anticoagulation satisfaction. Change in anticoagulation satisfaction varied substantially following extended-interval monitoring, with no evidence of improved satisfaction. Plausible reasons for patients not preferring extended-interval monitoring include increased anxiety and disengagement from self-management activities, both potentially related to less frequent feedback and reassurance during extended interval-monitoring. Additional research is needed to identify who is likely to benefit most from extended-interval monitoring. Anticoagulation satisfaction should be considered with clinical factors and shared-decision making when implementing extended-interval warfarin monitoring.
- Subjects :
- Male
medicine.medical_specialty
Pilot Projects
030204 cardiovascular system & hematology
03 medical and health sciences
0302 clinical medicine
Patient satisfaction
medicine
Humans
030212 general & internal medicine
Prospective Studies
Prospective cohort study
Aged
DASS
business.industry
Warfarin
Hematology
Guideline
Middle Aged
Additional research
Surgery
Patient Satisfaction
Emergency medicine
Warfarin monitoring
Anxiety
Female
medicine.symptom
Drug Monitoring
Cardiology and Cardiovascular Medicine
business
medicine.drug
Subjects
Details
- ISSN :
- 1573742X
- Volume :
- 42
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Journal of thrombosis and thrombolysis
- Accession number :
- edsair.doi.dedup.....f70969faf4c6eef7ee25f5ce688f2905