ADHERENCE TO ANTICOAGULANT THERAPY AND ITS AWARENESS AMONG CARDIAC PATIENTS ATTENDING CARDIAC OPD OF CHITWAN MEDICAL COLLEGE TEACHING HOSPITAL, CHITWAN

D. Khanal, S. Chapagain, Soni Kc, Sadikshya Neupanae
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Abstract

Background: Oral Anti-coagulant is widely used for the prevention and treatment of cardiac and thromboembolic diseases. As oral anticoagulant is a narrow therapeutic index medicine, it requires close monitoring to achieve effectiveness of anticoagulants therapy. Therefore, this study was conducted to assess adherence to anticoagulant therapy and its awareness among cardiac patients attending cardiac OPD of Chitwan Medical College Teaching Hospital, Chitwan. Methods: A descriptive cross-sectional study design was carried out among 91 cardiac patients attending cardiac OPD of Chitwan Medical College Teaching Hospital sample was selected by using Consecutive sampling technique. Data was collected using structured interview schedule. General medication adherence scale and self-prepared structured questionnaire of awareness of anticoagulant therapy was used.  Data was analyzed in SPSS version 20 by using descriptive and inferential statistics. Results: Out of 91 respondents 42.9% of the respondents had partial adherence while 33.0% had good adherence. Only 6% of the respondents had high adherence, 7.7% and 9.9% of the respondents had poor and low respectively. Regarding awareness of anticoagulant therapy 63.7% of the respondents had inadequate level of awareness. There was statistically significant relationship between level of awareness with educational status (0.02), having insurance (0.05) and drug duration (0.05). Conclusions: Based on this finding respondent’s awareness was found to be low on the risk effects of alcohol intake, drugs and food interaction and self-limiting of injurious activities and most identified reason for non-adherence is discontinue due to feeling well, adverse effect and progression of disease. So, clinician and nurse should design an effective instructional program about anticoagulant therapy by highlighting those limited area thus to enhance adherence and prevent life threatening complications.
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赤湾医学院附属医院心内科心脏病患者抗凝治疗依从性及知晓率
背景:口服抗凝剂广泛应用于心脏和血栓栓塞性疾病的预防和治疗。口服抗凝药是一种治疗指标较窄的药物,需要密切监测才能达到抗凝治疗的效果。因此,本研究旨在评估Chitwan医学院附属医院心内科急诊科心脏病患者抗凝治疗依从性及抗凝治疗意识。方法:采用描述性横断面研究设计,采用连续抽样方法对在奇旺医学院附属医院心内科门诊就诊的91例心脏病患者进行抽样调查。数据收集采用结构化访谈计划。采用一般药物依从性量表和自行编制的结构化抗凝治疗认知问卷。数据在SPSS version 20中进行分析,采用描述统计和推理统计。结果:91名应答者中,42.9%的应答者部分依从,33.0%的应答者良好依从。只有6%的受访者依从性高,7.7%的受访者依从性差,9.9%的受访者依从性低。在抗凝治疗知晓率方面,63.7%的被调查者对抗凝治疗知晓率不高。知晓率与受教育程度(0.02)、是否有保险(0.05)、用药时间(0.05)有统计学意义。结论:基于这一发现,受访者对酒精摄入、药物和食物相互作用以及自我限制有害活动的风险影响的认识较低,大多数确定的不坚持的原因是由于感觉良好、不良反应和疾病进展而停止。因此,临床医生和护士应设计有效的抗凝治疗指导方案,突出这些局限性,从而提高依从性,预防危及生命的并发症。
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