Relationship Between Anticoagulant Medication Adherence and Satisfaction in Patients With Stroke

J Neurosci Nurs. 2019 Oct;51(5):229-234. doi: 10.1097/JNN.0000000000000463.

Abstract

Aim: The aim of this study was to investigate the accuracy of the self-reported measure of adherence and the relation between adherence to warfarin use, demographic and clinical variables, and the satisfaction with the treatment in patients affected by stroke.

Methods: This is a correlational, quantitative, and cross-sectional study, carried out in the outpatient clinics of a public university hospital from October 2017 to April 2018. Sociodemographic and clinical data were collected through interviews and hospital charts, as well as by applying the Measurement of Treatment Adherence (MTA) and the Duke Anticoagulation Satisfaction Scale, in their Brazilian versions. Results of the international normalized ratio (INR) were collected. Measurements of accuracy of the MTA scale were calculated in relation to the INR classification.

Results: Of 99 patients (55.6% male with a mean age of 58.6 years), 57.6% presented with therapeutic INR values and 75.8% of the patients were adherent to the oral anticoagulant therapy according to the MTA. The accuracy analysis of the measurement provided by the MTA scale in relation to the INR classification showed a sensitivity of 77.2% and a specificity of 26.2%. The patients' satisfaction with the treatment was high. The Duke Anticoagulation Satisfaction Scale had an average total score of 46.4, with the dimension impact in the field having the highest score (20.3).

Conclusion: Stroke patients were adherent and satisfied with the oral anticoagulant therapy. The MTA had good sensitivity and poor specificity. Sociodemographic and clinical characteristics identified were not associated with adherence and satisfaction with treatment.

MeSH terms

  • Anticoagulants / therapeutic use*
  • Brazil
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Humans
  • International Normalized Ratio / statistics & numerical data
  • Male
  • Medication Adherence / statistics & numerical data*
  • Middle Aged
  • Patient Satisfaction / statistics & numerical data*
  • Self Report
  • Sensitivity and Specificity
  • Stroke / drug therapy*
  • Surveys and Questionnaires
  • Warfarin / therapeutic use*

Substances

  • Anticoagulants
  • Warfarin