Yusuf ÇEKİCİ, Salih KILIÇ, Erhan SARAÇOĞLU, Dilara Deniz KILIÇ, Arafat YILDIRIM, Zülfiye KUZU

Effcts of Regular Follow-up on Quality of Life and Warfarin Effiency in Rural Patients

Objective: This study aims to evaluate the effects of regular follow-up and education on warfarin efficiency, satisfaction, and thequality of life in patients from rural areas.Methods: A total of 133 patients from rural areas taking warfarin were followed up for the mean of 17.4±0.5 months (mean age58±13 years, 72.9% female). All patients were educated and followed up by a single cardiologist prospectively. A list and an illustratedbooklet presenting foods that interact with warfarin and a follow-up chart were prepared for each patient. An illustrated scheme ofpills that were to be taken every day was prepared for illiterate patients. The international normalized ratio (INR) values during and1 year before the study were recorded from the hospital system, and the time in therapeutic range (TTR) was calculated. The DukeAnticoagulation Satisfaction Scale was conducted at the start and end of the study to determine patients’ satisfaction with warfarinuse. Furthermore, the Medical Outcomes Study Form 36 (SF-36) was used for determining the health-related quality of life (HRQoL).Results: A total of 45.9% of patients were illiterate, and 33.8% were primary school graduates. The median TTR during the follow-up increased significantly compared with the previous year [40.0 (IQR 36.5) vs. 62.1 (IQR 29.3); p70% increased significantly (36.8% vs. 21.1%, respectively; p

PDF

___

1. Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, et al. 2012 focused update of the ESC Guidelines for the management of atrial firillation. Eur Heart J 2012; 33: 2719-47. [CrossRef]
2. Turk UO, Tuncer E, Alioglu E, Yuksel K, Pekel N, Ozpelit E, et al. Evaluation of the impact of warfarin time in therapeutic range on outcomes of patients with atrial firillation in Turkey: Perspectives from the observational, prospective WATER Registry. Cardiol J 2015; 22: 567-75. [CrossRef]
3. Ertaş F, Kaya H, Kaya Z, Bulur S, Köse N, Gül M, et al. Epidemiology of atrial fibrillation in Turkey: preliminary results of the multicenter AFTER study. Turk Kardiyol Dern Ars 2013; 41: 99-104. [CrossRef]
4. Çelik A, İzci S, Kobat MA, Ateş AH, Çakmak A, Çakıllı Y, et al. The awareness, efficy, safety, and time in therapeutic range of warfarin in the Turkish population: WARFARIN-TR. Anatol J Cardiol 2016;16:595-600. [CrossRef]
5. Tang EO, Lai CS, Lee KK, Wong RS, Cheng G, Chan TY. Relationship between patients’ warfarin knowledge and anticoagulation control. Ann Pharmacother 2003; 37: 34-9. [CrossRef]
6. Casais P, Meschengieser S, Sanchez-Luceros A, Lazzari M. Patients’ perceptions regarding oral anticoagulation therapy and its effect on quality of life. Curr Med Res Opin 2005; 21: 1085-90. [CrossRef]
7. Samsa G, Matchar DB, Dolor RJ, Wiklund I, Hedner E, Wygant G, et al. A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation. Health Qual Life Outcomes 2004; 2: 22. [CrossRef]
8. Tokgözoğlu L, Oğuz A, Balcı MK, Temizhan A, Altunoğlu EG, Bektaş O, et al. Turkish assessment of SURF (SUrvey of Risk Factor Management) study: Control rates of cardiovascular risk factors derived from databases of 15 diffrent levels of health centers in Turkey. Turk Kardiyol Dern Ars 2017; 45: 398-407.
9. Rosendaal F, Cannegieter S, van der Meer F, Briët E. A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost 1993;69:236-9. [CrossRef]
10. Samsa G, Matchar DB, Dolor RJ, Wiklund I, Hedner E, Wygant G, et al. A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation. Health Qual Life Outcomes 2004; 2: 22. [CrossRef]
11. Stewart AL, Hays RD, Ware JE Jr. The MOS short-form general health survey: reliability and validity in a patient population. Med Care 1988; 26: 724-35. [CrossRef]
12. Yıldırım JG, Temel AB. Duke antikoagülan memnuniyet ölçeğinin Türkçe formunun geçerlik ve güvenirliği. Turk Gogus Kalp Dama 2014; 22: 761-72. [CrossRef]
13. Koçyiğit H, Aydemir Ö, Fişek G, Ölmez N, Memiş A. Kısa Form-36 (KF- 36)’nın Türkçe versiyonunun güvenilirliği ve geçerliliği. İlaç Tedavi Derg 1999; 12: 102-6.
14. Kılıç S, Çelik A, Çakmak HA, Afşin A, Tekkeşin Aİ, Açıksarı G, et al. The time in therapeutic range and bleeding complications of warfarin in diffrent geographic regions of Turkey: a subgroup analysis of WARFARIN-TR Study. Balkan Med J 2017; 34: 349-55. [CrossRef]
15. Connock M, Stevens C, Fry-Smith A, Jowett S, Fitzmaurice D, Moore D, et al. Clinical effctiveness and cost-effctiveness of diffrent models of managing long-term oral anticoagulation therapy: a systematic review and economic modelling. Health Technol Assess 2007; 11: ix-66. [CrossRef]
16. Heneghan C, Alonso-Coello P, Garcia-Alamino J, Perera R, Meats E, Glasziou P. Self-monitoring of oral anticoagulation: a systematic review and meta-analysis. Lancet 2006; 367: 404-11. [CrossRef]
17. Garcia-Alamino JM, Ward AM, Alonso-Coello P, Perera R, Bankhead C, Fitzmaurice D, et al. Self-monitoring and self-management of oral anticoagulation. Sao Paulo Med J 2010; 128: 246. [CrossRef]
18. Kılıç S, Soner Kemal H, Yüce Eİ, Şimşek E, Yağmur B, Memişoğlu Akgül N, et al. Comparison of Warfarin use in terms of efficy and safety in two diffrent polyclinics. Anatol J Cardiol 2017; 18: 328-33. [CrossRef]
19. Ansell J, Jacobson A, Levy J, Völler H, Hasenkam JM; International Self-Monitoring Association for Oral Anticoagulation. Guidelines for implementation of patient self-testing and patient self-management of oral anticoagulation. International consensus guidelines prepared by International Self-Monitoring Association for Oral Anticoagulation. Int J Cardiol 2005; 99: 37-45. [CrossRef]
20. Prins MH, Marrel A, Carita P, Anderson D, Bousser MG, Crijns H, et al. Multinational development of a questionnaire assessing patient satisfaction with anticoagulant treatment: the ‘Perception of Anticoagulant Treatment Questionnaire’ (PACT-Q). Health Qual life Outcomes 2009; 7: 9. [CrossRef]
21. Dantas GC, Thompson BV, Manson JA, Tracy CS, Upshur RE. Patients’ perspectives on taking warfarin: qualitative study in family practice. BMC Fam Pract 2004; 5: 15. [CrossRef]
22. Carris NW, Hwang AY, Smith SM, Taylor JR, Sando K, Powell J, et al. Patient satisfaction with extended-interval warfarin monitoring. J Thromb Thrombolysis 2016; 42: 486-93. [CrossRef]
23. Kneeland PP, Fang MC. Current issues in patient adherence and persistence: focus on anticoagulants for the treatment and prevention of thromboembolism. Patient Prefer Adherence 2010; 4: 51-60. [CrossRef]
24. Das AK, Ahmed A, Corrado OJ, West RM. Quality of life of elderly people on warfarin for atrial firillation. Age Ageing 2009; 38: 751-4. [CrossRef]
25. Pelegrino FM, Dantas RA, Corbi IS, da Silva Carvalho AR, Schmidt A, Pazin Filho A. Cross-cultural adaptation and psychometric properties of the Brazilian-Portuguese version of the Duke Anticoagulation Satisfaction Scale. J Clin Nurs 2012; 21: 2509-17. [CrossRef]
26. Corbi IS, Dantas RA, Pelegrino FM, Carvalho AR. Health related quality of life of patients undergoing oral anticoagulation therapy. Rev Lat Am Enfermagem 2011; 19: 865-73. [CrossRef]
27. Wallentin L, Yusuf S, Ezekowitz MD, Alings M, Flather M, Franzosi MG, et al. Efficy and safety of dabigatran compared with warfarin at diffrent levels of international normalised ratio control for stroke prevention in atrial firillation: an analysis of the RE-LY trial. Lancet 2010; 376: 975-83. [CrossRef]
28. Lopes RD, Alexander JH, Al-Khatib SM, Ansell J, Diaz R, Easton JD, et al. Apixaban for reduction in stroke and other ThromboemboLic events in atrial firillation (ARISTOTLE) trial: design and rationale. Am Heart J 2010; 159: 331-9. [CrossRef]
29. ROCKET AF Study Investigators. Rivaroxaban-once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and Embolism Trial in Atrial Fibrillation: Rationale and Design of the ROCKET AF study. Am Heart J 2010; 159: 340-7. [CrossRef]
30. Ruf CT, Giugliano RP, Antman EM, Crugnale SE, Bocanegra T, Mercuri M, et al. Evaluation of the novel factor Xa inhibitor edoxaban compared with warfarin in patients with atrial firillation: Design and rationale for the Effctive aNticoaGulation with factor xA next GEneration in Atrial Fibrillation–Thrombolysis In Myocardial Infarction study 48 (ENGAGE AF–TIMI 48). Am Heart J 2010; 160: 635-41. [CrossRef]