title: Impact of video technology on efficiency of pharmacist-provided anticoagulation counseling and patient comprehension.
abstract: BACKGROUND
  Discharge anticoagulation counseling is important for ensuring patient comprehension and optimizing clinical outcomes. As pharmacy resources become increasingly limited, the impact of informational videos on the counseling process becomes more relevant.
  
  
  OBJECTIVE
  To evaluate differences in pharmacist time spent counseling and patient comprehension (measured by the Oral Anticoagulation Knowledge [OAK] test) between informational videos and traditional face-to-face (oral) counseling.
  
  
  METHODS
  This prospective, open, parallel-group study at an academic medical center randomized 40 individuals-17 warfarin-naïve ("New Start") and 23 with prior warfarin use ("Restart")-to receive warfarin discharge education by video or face-to-face counseling. "Teach-back" questions were used in both groups.
  
  
  RESULTS
  Although overall pharmacist time was reduced in the video counseling group (P < 0.001), an interaction between prior warfarin use and counseling method (P = 0.012) suggests the difference between counseling methods was smaller in New Start participants. Following adjustment, mean total time was reduced 8.71 (95% CI = 5.15-12.26) minutes (adjusted P < 0.001) in Restart participants and 2.31 (-2.19 to 6.81) minutes (adjusted P = 0.472) in New Start participants receiving video counseling. Postcounseling OAK test scores did not differ. Age, gender, socioeconomic status, and years of education were not predictive of total time or OAK test score.
  
  
  CONCLUSIONS
  Use of informational videos coupled with teach-back questions significantly reduced pharmacist time spent on anticoagulation counseling without compromising short-term patient comprehension, primarily in patients with prior warfarin use. Study results demonstrate that video technology provides an efficient method of anticoagulation counseling while achieving similar comprehension.
authors: Wake Forest Baptist Health, Winston-Salem, NC, USA sarahjohannesmoore@gmail.com.
authors: Sarah J
authors: SJ
authors: Moore
authors: GlaxoSmithKline, Research Triangle Park, NC, USA.
authors: Elizabeth A
authors: EA
authors: Blair
authors: UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA.
authors: David R
authors: DR
authors: Steeb
authors: University of Maryland School of Pharmacy, Baltimore, MD, USA.
authors: Brent N
authors: BN
authors: Reed
authors: UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA.
authors: J Heyward
authors: JH
authors: Hull
authors: UNC Eshelman School of Pharmacy, Chapel Hill, NC, USA.
authors: Jo Ellen
authors: JE
authors: Rodgers
mesh_terms: D000046:Academic Medical Centers; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D032882:Comprehension; D003376:Counseling / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D010595:Pharmacists / Q000458:organization & administration*; D011446:Prospective Studies; D014859:Warfarin / Q000627:therapeutic use*
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: anticoagulation; counseling; patient education; safety; technology; video; warfarin