The development and performance validation of a tool to assess patient anticoagulation knowledge

Abstract

Background The complexity of anticoagulation therapy requires a patient's command of anticoagulation-related knowledge to assist in maintaining optimal therapy and reducing adverse events. Verbal evaluations may overestimate the patient's comprehension of anticoagulation knowledge. Objectives This first phase study developed and pilot tested the Anticoagulation Knowledge Assessment (AKA) instrument, and provided validity evidence to support the use of the AKA. The AKA is an assessment instrument that (1) pharmacists can use to obtain objective evidence of patient anticoagulation knowledge, (2) can provide pharmacists with direction for patient-specific medication management education, and (3) functions as a tool for continuous quality improvement in anticoagulation education. Methods Using objective measurement methods, a convenience sample of 60 English-speaking patients receiving services from an inner-city and suburban pharmacist managed anticoagulation clinics was used in conjunction with objective measurement methods. Results Rasch analysis of 32 multiple-choice items representing 10 anticoagulation educational content areas demonstrated misfit statistics of less than 1.2. All 60 patients demonstrated person misfit statistics of less than 1.3. The educational content area was well represented and distributed. Conclusions Because the AKA performed well, the data support that information gained from the AKA will provide pharmacists with direction for anticoagulation management education that is targeted to each patient's specific needs. Additionally, responses demonstrated objective data about those components of practice that are being taught effectively.