A Survey of Demographic Characteristics, Warfarin Clinical Usage, Related Knowledge and Medication Adherence of Warfarin-Taken Patients

• Main Authors: Pai-En Chiu, 邱白恩
• Other Authors: Chuan-Hsiu Tsai
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/79355612123240517304

碩士 === 慈濟大學 === 護理學系碩士班 === 102 === Background and research objective: The therapeutic window of anticoagulant Warfarin is narrow, effective treatment depends on the good adherence and regular follow-up visits. Medication adherence in patient taking Warfarin may be one of critical issues. This study was to investigate the relationship between the demographic, clinical usage, knowledge of Warfarin and medication adherence in these patients. Methods: A cross-sectional design and purposive sampling was conducted, the patients who took Warfarin and visited an outpatient clinic of a hospital in Yilan City were included. Structured questionnaires and medical records were collected. The knowledge of Warfarin was assessed by questionnaires. The subjective medication adherence was evaluated by Visual Analogue Scale （VAS） and 8-item Morisky Medication Adherence Scale （MMAS-8）. The objective medication adherence was evaluated by chart review, included Medication Refill Adherence （MRA） and Time in the Therapeutic Range （TTR）. Results: One hundred ninety-two participants were included and the mean age was 69.6 years old, mean comorbilities was 1.8. Mean dose of Warfarin therapy was 21.7mg per week, mean duration of months on Warfarin use was 50 months. Fifty nine point four percent patients took more than six medications. Mean knowledge score was 6.67 （±2.22） of a maximum score of 10. Significant difference was found among different age groups on subjective and objective medication adherence （p<.05）. The influencing factors to medication adherence included duration of prescription, comorbidities and polypharmacy. Good knowledge of patient, either in subjective and objective medication adherence, is associated with good adherence, but it is not related to optimal TTR or fewer complications. Conculsions: The subjective and objective medication adherence was affected by age, usage duration, cormobidities, polypharmacy and knowledge. On the other hand, the determinating factors of TTR merit further research.