title: Patients' attitude and knowledge about oral anticoagulation therapy: results of a self-assessment survey in patients with atrial fibrillation conducted by the European Heart Rhythm Association.
abstract: The purpose of this European Heart Rhythm Association survey was to assess the attitude, level of education, and knowledge concerning oral anticoagulants (OACs) among patients with atrial fibrillation (AF) taking vitamin K antagonists (VKAs), non-VKA oral anticoagulants (NOACs) or antiplatelets. A total of 1147 patients with AF [mean age 66 ± 13 years, 529 (45%) women] from 8 selected European countries responded to this survey. The overall use of OACs and antiplatelets was 77 and 15.3%, respectively. Of the patients taking OACs, 67% were on VKAs, 33% on NOACs, and 17.9% on a combination of OACs and antiplatelets. Among patients on VKAs, 91% correctly stated the target international normalized ratio (INR) level. The proportion of patients on VKA medication who were aware that monthly INR monitoring was required for this treatment and the proportion of patients on NOAC who knew that renal function monitoring at least annually was mandatory for NOACs was 76 and 21%, respectively. An indirect estimation of compliance indicated that 14.5% of patients temporarily discontinued the treatment, and 26.5% of patients reported having missed at least one dose. The survey shows that there is room for improvement regarding education and adherence of patients taking OACs, particularly regarding monitoring requirements for NOACs.
authors.affiliation: Department of Cardiology, Groupe Hospitalier Le Raincy-Montfermeil, Montfermeil, France.
authors.forename: Walid
authors.initials: W
authors.lastname: Amara
authors.affiliation: Department of Cardiology, AF Studygroup, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Torben B
authors.initials: TB
authors.lastname: Larsen
authors.affiliation: Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala, Sweden.
authors.forename: Elena
authors.initials: E
authors.lastname: Sciaraffia
authors.affiliation: Cardiology Department, Ramón y Cajal Hospital, Alcala University, 28034 Madrid, Spain antoniomadri@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernández Madrid
authors.affiliation: Department of Heart Disease, Haukeland University Hospital, Bergen, Norway Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Cardiology, MedizinischeKlinik I, Ludwig-Maximilians-Universität, Campus Großhadern, Marchioninistrasse 15, München 81377, Germany.
authors.forename: Heidi
authors.initials: H
authors.lastname: Estner
authors.affiliation: Manchester Heart Centre, Manchester, UK.
authors.forename: Derick
authors.initials: D
authors.lastname: Todd
authors.affiliation: 2nd Cardiology Department, University Hospital of Pisa, Pisa, Italy.
authors.forename: Maria G
authors.initials: MG
authors.lastname: Bongiorni
authors.affiliation: School of Medicine, University of Belgrade, Belgrade, Serbia Cardiology Clinic, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Tatjana S
authors.initials: TS
authors.lastname: Potpara
authors.affiliation: Second Cardiology Department, Attikon University Hospital, University of Athens, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Dagres
authors.affiliation: Cardioloy Department, Centre Hospitalier William Marey, 71100 Chalon s/Saone, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Sagnol
authors.affiliation: Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala, Sweden.
authors.forename: Carina
authors.initials: C
authors.lastname: Blomstrom-Lundqvist
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000453:epidemiology / Q000523:psychology; D001294:Attitude to Health; D059026:Diagnostic Self Evaluation; D005060:Europe / Q000453:epidemiology; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D010353:Patient Education as Topic / Q000706:statistics & numerical data*; D063046:Patient Medication Knowledge / Q000706:statistics & numerical data*; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage; D013923:Thromboembolism / Q000453:epidemiology / Q000517:prevention & control* / Q000523:psychology; D014812:Vitamin K / Q000037:antagonists & inhibitors; D016903:Drug Monitoring
chemical_list: D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors; D014812:Vitamin K
keywords: Atrial fibrillation; CHA2DS2-VASc; Guidelines; Non-vitamin K antagonist oral anticoagulants; Oral anticoagulants; Patient awareness; Risk; Stroke; Survey; Vitamin K antagonists