Abstract
Introduction: Effective anticoagulation depends on demographic factors, patient education, drug knowledge and compliance. The aim of our study is to determine the factors that influence compliance to warfarin in the mechanical valve patient population and its relationship with thrombo-embolic and bleeding events. Patients and Methods: 113 patients underwent mechanical valve replacement (Aortic, mitral or both) at King Abdul-Aziz University Hospital, from 2006 to 2012, patients divided into two groups according to warfarin compliant. Results: 113 patients reviewed in our study, 69 (61.1%) patients found compliant, 36 (31.9%) patients found non compliant, and 8 (7.1%) patients missed. The mean age for all patients was 39.25 y: 76 (67.3%) ware male, 37 (32.7%) were female. Mean age for compliant patients was 40.19 y versus 33.3 y for noncompliant patients with p value 0.017. Male patient less complaint than female with significant 0.01, the mean frequency of follow up was less (32.32 days) in compliant vs. (67.73 days) in non complaint patient. Conclusion: younger age, female gender, Arabic race, assistance at home, education, and single drug use are factors associated with patient compliant, non compliance are associated with higher mortality and valve related complication.
Highlights
Effective anticoagulation depends on demographic factors, patient education, drug knowledge and compliance
Patients who have undergone mechanical valve implantation require lifelong oral anticoagulation treatment to allow adequate valve function and prevent thromboembolism [1]. These patients require regular clinic visits in order to monitor their International Normalized Ratio (INR), which reflects the level of anticoagulation
One hundred thirteen patients reviewed in our study, sixty nine (61.1%) patients found compliant, thirty six (31.9%) patients found non compliant, and eight (7.1%) patients missed
Summary
Effective anticoagulation depends on demographic factors, patient education, drug knowledge and compliance. Conclusion: younger age, female gender, Arabic race, assistance at home, education, and single drug use are factors associated with patient compliant, non compliance are associated with higher mortality and valve related complication. Patients who have undergone mechanical valve implantation require lifelong oral anticoagulation treatment to allow adequate valve function and prevent thromboembolism [1]. These patients require regular clinic visits in order to monitor their International Normalized Ratio (INR), which reflects the level of anticoagulation. Effective anticoagulation is dependent on addressing a number of patient-related factors These include demographic factors, patient education, drug knowledge and compliance [3] [4]. Another study showed that 36% of out-of-range INR readings were secondary to noncompliance [6]
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