Anticoagulation education: Do patients understand potential medication-related emergencies?

Christopher Moreland, Richard L. Kravitz, Debora A. Paterniti, Chin Shang Li, Tzu Chun Lin, Richard H. White

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The Joint Commission Venous Thrombo - embolism (VTE) National Hospital Inpatient Quality Measure VTE-5 outlines four criteria for discharge patient education when starting anticoagulation (usually, warfarin) therapy. The criteria do not specify content regarding patient recognition of potentially dangerous warfarin-related scenarios. A study was conducted to investigate how well patients assess the risks and consequences of potential warfarin-related safety threats. Methods: From an adult population on long-term warfarin, 480 patients were randomly selected for a telephone-based survey. Warfarin-knowledge questions were drawn from a previous survey; warfarin-associated risk scenarios were developed via focus interviews. Expert anticoagulation pharmacists categorized each scenario as urgent, moderately urgent, or not urgent, as did survey participants. Results: For the 184 patients (38% completion rate), the mean knowledge score was 69% (standard deviation [SD], 0.20). Overall classification accuracy of situational urgency was 59% (95% confidence interval [CI], 57.3%-60.3%). Respondents overestimated non-urgent-severity situations 23% of the time (95% CI, 20.8%-24.7%), while underestimating urgent-severity situations 21% of the time (95% CI, 19.0%-23.9%). A significant percentage of patients failed to recognize the urgency of stroke symptoms (for example, loss of vision), the risk of bleeding after incidental head trauma, or medication mismanagement. Conclusions: Despite fair factual warfarin knowledge, participants did not appear to recognize well the clinical severity of warfarin-associated scenarios. Warfarin education programs should incorporate patient-centered strategies to teach recognition of high-risk situations that compromise patient safety.

Original languageEnglish (US)
Pages (from-to)22-31
Number of pages10
JournalJoint Commission Journal on Quality and Patient Safety
Volume39
Issue number1
StatePublished - Jan 2013

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Warfarin
Patient Education
Emergencies
Confidence Intervals
Embolism
Patient Safety
Craniocerebral Trauma
Pharmacists
Telephone
Inpatients
Joints
Stroke
Interviews
Hemorrhage
Safety
Education
Surveys and Questionnaires

ASJC Scopus subject areas

  • Leadership and Management

Cite this

Moreland, C., Kravitz, R. L., Paterniti, D. A., Li, C. S., Lin, T. C., & White, R. H. (2013). Anticoagulation education: Do patients understand potential medication-related emergencies? Joint Commission Journal on Quality and Patient Safety, 39(1), 22-31.

Anticoagulation education : Do patients understand potential medication-related emergencies? / Moreland, Christopher; Kravitz, Richard L.; Paterniti, Debora A.; Li, Chin Shang; Lin, Tzu Chun; White, Richard H.

In: Joint Commission Journal on Quality and Patient Safety, Vol. 39, No. 1, 01.2013, p. 22-31.

Research output: Contribution to journalArticle

Moreland, C, Kravitz, RL, Paterniti, DA, Li, CS, Lin, TC & White, RH 2013, 'Anticoagulation education: Do patients understand potential medication-related emergencies?', Joint Commission Journal on Quality and Patient Safety, vol. 39, no. 1, pp. 22-31.
Moreland, Christopher ; Kravitz, Richard L. ; Paterniti, Debora A. ; Li, Chin Shang ; Lin, Tzu Chun ; White, Richard H. / Anticoagulation education : Do patients understand potential medication-related emergencies?. In: Joint Commission Journal on Quality and Patient Safety. 2013 ; Vol. 39, No. 1. pp. 22-31.
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