Effects of intensive, targeted education by pharmacists on anticoagulant patients with atrial fibrillation: a multicentre randomized controlled trial from China

Eur J Cardiovasc Nurs. 2024 Dec 16;23(8):935-944. doi: 10.1093/eurjcn/zvae092.

Abstract

Aims: Many people diagnosed with atrial fibrillation (AF) may lack awareness of AF and anticoagulants. The purpose of this study is to investigate the effects of intensive, targeted education by pharmacists on anticoagulant patients with AF.

Methods and results: Three hundred seventy-six AF patients were randomly assigned to receive standard care or pharmacist education. Follow-up is scheduled after 1, 3, 6, and 12 months. Pharmacists provided intensive education on knowledge deficits revealed by the Jessa Atrial fibrillation Knowledge Questionnaire (JAKQ) during each visit. Patients also completed two questionnaires to assess their medication adherence and satisfaction. Clinical outcomes were recorded during follow-up. Three hundred sixty-one patients completed follow-up. Baseline scores on the JAKQ were similar in the education group (median: 31.3%) and the standard care group (median: 31.3%) (P = 0.911). Over time, the knowledge score of the education group increased significantly (1 month: 68.8%, 3 months: 81.3%; P < 0.001), while there was no significant improvement in the standard care group (1 month: 37.5%, 3 months: 37.5%; P = 0.314). Adherence scores improved significantly over time in the education group (P < 0.001) but not in the standard care group (P = 0.101). Compared with standard care, pharmacist education was associated with a significantly lower risk of bleeding (P = 0.034).

Conclusion: Given the knowledge deficiency of AF patients in China, standardized patient education should be a part of their daily care. Pharmacist-led education intervention can significantly improve the disease-related knowledge, medication adherence, and drug treatment satisfaction of AF patients while significantly reducing the risk of bleeding.

Registration: ChiCTR1900024455.

Keywords: Anticoagulation; Atrial fibrillation; Education; Knowledge; Pharmacist.

Publication types

  • Randomized Controlled Trial
  • Multicenter Study

MeSH terms

  • Aged
  • Anticoagulants* / administration & dosage
  • Anticoagulants* / therapeutic use
  • Atrial Fibrillation* / drug therapy
  • China
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Male
  • Medication Adherence / psychology
  • Medication Adherence / statistics & numerical data
  • Middle Aged
  • Patient Education as Topic* / methods
  • Pharmacists*
  • Surveys and Questionnaires

Substances

  • Anticoagulants