Abstract
Objectives:To evaluate health care professionals’ knowledge on warfarin interactions with drugs and herbs.Methods:A self-administered questionnaire was developed to assess health care professionals’ knowledge on warfarin interactions with drug and herb. Respondents were asked to classify 15 drugs that may effect on warfarin action as “enhance”, “inhibit “, “no effect”. The study sample involved health care professionals (physicians, pharmacists and nurses) from king Salman hospital, Saudi Arabia.Results:About 92.2% of health care professionals identified warfarin interactions with aspirin, 4.4% for warfarin and fluoxetine. Warfarin and cardiac agents (atenolol) was correctly identified by 11.1% of respondents. In warfarin –herb interactions section, the majority of respondents (66.7%) identified the interaction between green tea and warfarin. Approximately one-third of respondents (n=33) correctly classified warfarin interactions with cardamom. No significant difference was found between the health care professionals (p=0.49) for warfarin-drug interactions knowledge score and p= 0.52 for warfarin- herb interactions knowledge score.Conclusion:This study suggests that health care professionals’ knowledge of warfarin- drug-herb interactions was inadequate. Therefore, health care professionals should receive more education programs about drug-drug/herb interactions to provide appropriate patient counseling and optimal therapeutic outcomes.
Highlights
Warfarin is the most commonly used oral anticoagulant and has been used in preventing thromboembolic events in patients with chronic arterial fibrillation, prosthetic heart valves, venous thrombosis canonry hear disorders.[1,2,3] Mode of action of Warfarin believes to exert its effect by lowering the amount of active vitamin K available for the activation of clotting factors II, VII, IX, and X.4 Use of warfarin is still limited despite the strong evidence for its clinical value
Kruskal-Wallis test showed that there is no significant difference (p>0.05) between the three groups regarding their knowledge of warfarin drug-drug interactions
The result of the current study showed that the majority of the HCPs had poor knowledge on herb-warfarin interactions
Summary
Warfarin is the most commonly used oral anticoagulant and has been used in preventing thromboembolic events in patients with chronic arterial fibrillation, prosthetic heart valves, venous thrombosis canonry hear disorders.[1,2,3] Mode of action of Warfarin believes to exert its effect by lowering the amount of active vitamin K available for the activation of clotting factors II, VII, IX, and X.4 Use of warfarin is still limited despite the strong evidence for its clinical value. Warfarin is the most commonly used oral anticoagulant and has been used in preventing thromboembolic events in patients with chronic arterial fibrillation, prosthetic heart valves, venous thrombosis canonry hear disorders.[1,2,3] Mode of action of Warfarin believes to exert its effect by lowering the amount of active vitamin K available for the activation of clotting factors II, VII, IX, and X.4. Use of warfarin is still limited despite the strong evidence for its clinical value. This may be due to the narrow therapeutic index, warfarin’ drug and herb interactions, and resulting in non-therapeutic anticoagulation or life-threatening hemorrhagic complications.[5,6,7].
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