title: Factors affecting warfarin-related knowledge and INR control of patients attending physician- and pharmacist-managed anticoagulation clinics.
abstract: OBJECTIVE
  To assess the anticoagulation knowledge and international normalized ratio (INR) control among patients on warfarin.
  
  
  METHODS
  A cross-sectional study with 156 randomly sampled patients from physician- (non-medication therapy adherence clinic [non-MTAC]) and pharmacist (MTAC)-run anticoagulation clinics using a validated interviewer-administered questionnaire. Patients' INR readings from 2008 to 2010 were recorded.
  
  
  RESULTS
  Patients on warfarin scored an average of 66.5% ± 36.0% for their knowledge on how warfarin works, 42.9% ± 44.9% for interaction between warfarin and alcohol, and 49.2% ± 21.1% for adverse effects. No significant differences were found between MTAC and non-MTAC patients on their knowledge. There was a negative correlation between patients' knowledge and age (P = .001, r (s) = -.293) and a positive correlation between patients' knowledge and education level (P = .001, r (s) = .365). MTAC patients were found to have better INR control than non-MTAC when compared for mean percentage days in range (63.4% ± 18.9% vs 52.5% ± 18.2%; P = .006) and mean percentage visits in range (58.8% ± 17.9% vs 46.8% ± 18.6%; P = .001).
  
  
  CONCLUSIONS
  MTAC patients were found to have better INR control compared to non-MTAC patients. A joint cooperation between physicians, pharmacists, and nurses should exist to achieve desired therapeutic outcomes.
authors.affiliation: Department of Pharmacy Practice, School of Pharmacy and Health Sciences, International Medical University, Bukit Jalil, Kuala Lumpur, Malaysia. shahzad_hasan@imu.edu.my
authors.forename: Syed S
authors.initials: SS
authors.lastname: Hasan
authors.forename: R
authors.initials: R
authors.lastname: Shamala
authors.forename: Imran A
authors.initials: IA
authors.lastname: Syed
authors.forename: N
authors.initials: N
authors.lastname: Basariah
authors.forename: David W K
authors.initials: DW
authors.lastname: Chong
authors.forename: Teh K
authors.initials: TK
authors.lastname: Mei
authors.forename: Ong H
authors.initials: OH
authors.lastname: Chin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000554:Ambulatory Care Facilities / Q000458:organization & administration; D000925:Anticoagulants / Q000008:administration & dosage*; D001291:Attitude of Health Personnel; D001777:Blood Coagulation / Q000187:drug effects*; D003430:Cross-Sectional Studies; D016903:Drug Monitoring; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D019934:International Normalized Ratio; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D010595:Pharmacists; D010820:Physicians; D024382:Professional Role; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014859:Warfarin / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000925:Anticoagulants; D014859:Warfarin