title: Safety relevant knowledge of orally anticoagulated patients without self-monitoring: a baseline survey in primary care.
abstract: BACKGROUND
  Effective and safe management of oral anticoagulant treatment (OAT) requires a high level of patient knowledge and adherence. The aim of this study was to assess patient knowledge about OAT and factors associated with patient knowledge.
  
  
  METHODS
  This is a baseline survey of a cluster-randomized controlled trial in 22 general practices with an educational intervention for patients or their caregivers. We assessed knowledge about general information on OAT and key facts regarding nutrition, drug-interactions and other safety precautions of 345 patients at baseline.
  
  
  RESULTS
  Participants rated their knowledge about OAT as excellent to good (56%), moderate (36%) or poor (8%). However, there was a discrepancy between self-rated knowledge and evaluated actual knowledge and we observed serious knowledge gaps. Half of the participants (49%) were unaware of dietary recommendations. The majority (80%) did not know which non-prescription analgesic is the safest and 73% indicated they would not inform pharmacists about OAT. Many participants (35-75%) would not recognize important emergency situations. After adjustment in a multivariate analysis, older age and less than 10 years education remained significantly associated with lower overall score, but not with self-rated knowledge.
  
  
  CONCLUSIONS
  Patients have relevant knowledge gaps, potentially affecting safe and effective OAT. There is a need to assess patient knowledge and for structured education programs.
  
  
  BACKGROUND
  Deutsches Register Klinischer Studien (German Clinical Trials Register): DRKS00000586.Universal Trial Number (UTN U1111-1118-3464).
authors.affiliation: Department of General Practice, Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany. jchenot@uni-greifswald.de.
authors.forename: Jean-François
authors.initials: JF
authors.lastname: Chenot
authors.forename: Thanh Duc
authors.initials: TD
authors.lastname: Hua
authors.forename: Manar
authors.initials: M
authors.lastname: Abu Abed
authors.forename: Hannelore
authors.initials: H
authors.lastname: Schneider-Rudt
authors.forename: Tim
authors.initials: T
authors.lastname: Friede
authors.forename: Simon
authors.initials: S
authors.lastname: Schneider
authors.forename: Stefan Viktor
authors.initials: SV
authors.lastname: Vormfelde
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D003625:Data Collection; D005260:Female; D005858:Germany; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D055118:Medication Adherence; D011320:Primary Health Care; D012648:Self Care; D011795:Surveys and Questionnaires
chemical_list: D000925:Anticoagulants