title: Differences in attitude, education, and knowledge about oral anticoagulation therapy among patients with atrial fibrillation in Europe: result of a self-assessment patient survey conducted by the European Heart Rhythm Association.
abstract: The purpose of this patient survey was to analyse the knowledge about blood thinning medications relative to gender, age, education, and region of residence in patients with atrial fibrillation (AF). A total of 1147 patients with AF [mean age 66 ± 13 years, 529 (45%) women] from eight European countries responded to this survey. Most patients understood that the indication for anticoagulation therapy was to 'thin the blood', but 8.1% responded that the purpose of the medication was to treat the arrhythmia. Patients with college or university grades reported less frequent deviations from their target INR range compared with those without schooling (2.8% vs. 5.1%, P < 0.05). The awareness of anticoagulation-related risk of bleedings was lowest in patients without schooling (38.5%) and highest in those with college and university education (57.0%), P < 0.05. The same pattern was also observed regarding patient's awareness of non-vitamin K antagonist oral anticoagulants (NOACs): 56.5% of the patients with university education and only 20.5% of those without schooling (P < 0.05) knew about NOACs, indicating that information about new anticoagulation therapies remains well below the target. Bleeding events were statistically less frequent in patients on NOACs compared with vitamin K antagonists. The education level and patients' knowledge have a direct influence on the global management of the anticoagulation.
authors.affiliation: Cardiology Department, Ramón y Cajal Hospital, Alcala University, Ctra.Colmenar Viejo, km 9,100, Madrid 28034, Spain antoniomadri@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Hernández Madrid
authors.affiliation: School of Medicine, University of Belgrade, Belgrade, Serbia Cardiology Clinic, Clinical Center of Serbia, 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: Department of Heart Disease, Haukeland University Hospital, Haukeland, Norway Department of Clinical Science, University of Bergen, Bergen, Norway.
authors.forename: Jian
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Cardiology, AF Study group, Aalborg University Hospital, Aalborg, Denmark.
authors.forename: Torben B
authors.initials: TB
authors.lastname: Larsen
authors.affiliation: Department of Cardiology, MedizinischeKlinik I, Ludwig-Maximilians-Universität, Campus Großhadern, 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: Department of Cardiology, Institution of Medical Science, Uppsala University, Uppsala, Sweden.
authors.forename: Elena
authors.initials: E
authors.lastname: Sciaraffia
authors.affiliation: Division of Cardiology, University Hospital S. Maria della Misericordia, IRCAB Foundation Udine, Udine, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Proclemer
authors.affiliation: CH d'Avignon. Avignon, France.
authors.forename: Saida
authors.initials: S
authors.lastname: Cheggour
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, 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* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D001777:Blood Coagulation / Q000187:drug effects; D016903:Drug Monitoring / Q000379:methods; D004522:Educational Status; D005060:Europe; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D010353:Patient Education as Topic; D010361:Patients / Q000523:psychology*; D011237:Predictive Value of Tests; D018570:Risk Assessment; D012307:Risk Factors; D020521:Stroke / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome; D014812:Vitamin K / Q000037:antagonists & inhibitors
chemical_list: D000925:Anticoagulants; D014812:Vitamin K
keywords: Anticoagulation; Atrial fibrillation; EHRA survey; Non-vitamin K oral anticoagulants; Patient awareness; Stroke; Vitamin K antagonists