title: Barriers to warfarin use for stroke prevention in patients with atrial fibrillation in Hong Kong.
abstract: BACKGROUND
  Oral anticoagulation medications such as warfarin reduce the risk of stroke in atrial fibrillation (AF) but have been underutilized. This study aimed to investigate physicians' perceptions of stroke prevention management and patients' knowledge of AF and warfarin therapy in Hong Kong (HK).
  
  
  OBJECTIVE
  Both physician and patient's knowledge on warfarin use were the barriers for stroke prevention in patients with atrial fibrillation in Hong Kong.
  
  
  METHODS
  This prospective survey-based study was conducted between February 2011 and April 2011 to assess physicians' perceptions of stroke prevention management, patients' knowledge of AF, and patients' knowledge of warfarin therapy. The results were scored and compared with those in foreign countries.
  
  
  RESULTS
  Sixty-two physicians and 114 warfarin users were recruited in the study. The average score of HK physicians in the knowledge of stroke prevention therapy in AF patients was lower than that of Australian (AUS) family physicians (HK 2.48 vs AUS 4.02 out of 7). The mean scores of AF patients in Hong Kong regarding the knowledge of AF were lower than that of United Kingdom (UK) (HK 1.16 vs UK 2.24 out of 4) (P < 0.001) and that of Finland (FIN) (HK 2.77 vs FIN 5.94 out of 8) (P < 0.001), respectively. The mean score of AF patients in Hong Kong regarding the knowledge of warfarin therapy was lower than that of AF patients in the United States (US) (HK 2.39 vs US 3.92).
  
  
  CONCLUSIONS
  The barriers of warfarin use for AF patients in Hong Kong were related to both physicians and patients. Many Hong Kong physicians did not comply with international recommendations of stroke prevention in AF patients, and AF patients had a low knowledge level about the disease and warfarin therapy.
authors.affiliation: School of Pharmacy, Faculty of Medicine, the Chinese University of Hong Kong, Hong Kong. vivianlee@cuhk.edu.hk.
authors.forename: Vivian W Y
authors.initials: VW
authors.lastname: Lee
authors.forename: Cheuk Shing
authors.initials: CS
authors.lastname: Tam
authors.forename: Bryan P
authors.initials: BP
authors.lastname: Yan
authors.forename: Cheuk
authors.initials: C
authors.lastname: Man Yu
authors.forename: Yat
authors.initials: Y
authors.lastname: Yin Lam
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000704:Analysis of Variance; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000453:epidemiology; D001291:Attitude of Health Personnel; D016009:Chi-Square Distribution; D005260:Female; D019983:Guideline Adherence; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006723:Hong Kong / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011322:Primary Prevention / Q000379:methods*; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000453:epidemiology / Q000517:prevention & control*; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D014859:Warfarin