title: Knowledge regarding oral anticoagulation therapy among patients with stroke and those at high risk of thromboembolic events.
abstract: BACKGROUND
  Apart from atrial fibrillation, indications for oral anticoagulation common in our clinical practice include rheumatic heart disease and mechanical heart valve replacement. Evaluation of current patient knowledge regarding oral anticoagulation therapy (OAT) is the first step in improving the quality of anticoagulation therapy and patient care. The aim of the present study was to assess the knowledge regarding OAT among patients with stroke and those at high risk of thromboembolic events in a tertiary care hospital in India.
  
  
  METHODS
  A descriptive cross-sectional design was used; 240 patients on OAT because of various indications (mechanical heart valve replacement, rheumatic heart disease, atrial fibrillation, and stroke) attending the neurology and cardiology outpatient clinics and inpatient services were recruited. A structured self-developed questionnaire was used to assess the knowledge in these patients.
  
  
  RESULTS
  Most patients (62.9%) were ignorant about the target prothrombin time/international normalized ratio (PT/INR) levels with only 30% having their recent INR within the target range; 50% of the patients had a poor knowledge score, and the knowledge gap was most prominent in the domains of dietary interactions followed by drug interactions, adverse effects, and PT/INR monitoring. Knowledge score also had a significant association with gender, education, monthly income, and place of residence (P < .05).
  
  
  CONCLUSIONS
  Patient's knowledge about OAT was suboptimal. The findings support the need for educational interventions to improve the knowledge regarding OAT and, thereby, achieve an appropriate and safe secondary prevention of stroke.
authors.affiliation: College of Nursing, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Annu
authors.initials: A
authors.lastname: Alphonsa
authors.affiliation: College of Nursing, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Kamlesh K
authors.initials: KK
authors.lastname: Sharma
authors.affiliation: Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Gautam
authors.initials: G
authors.lastname: Sharma
authors.affiliation: Department of Neurology, All India Institute of Medical Sciences, New Delhi, India. Electronic address: rohitbhatia71@yahoo.com.
authors.forename: Rohit
authors.initials: R
authors.lastname: Bhatia
mesh_terms: D000284:Administration, Oral; D000293:Adolescent; D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D001777:Blood Coagulation / Q000187:drug effects; D054626:Consumer Health Information; D003430:Cross-Sectional Studies; D016903:Drug Monitoring / Q000379:methods; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007194:India / Q000453:epidemiology; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010361:Patients / Q000523:psychology*; D011517:Prothrombin Time; D058996:Quality Improvement; D019984:Quality Indicators, Health Care; D012008:Recurrence; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D020521:Stroke / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy*; D011795:Surveys and Questionnaires; D062606:Tertiary Care Centers; D013923:Thromboembolism / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D055815:Young Adult
chemical_list: D000925:Anticoagulants
keywords: Knowledge; atrial fibrillation; oral anticoagulation therapy; rheumatic heart disease; stroke; thromboembolic events