Authors (including presenting author) :
Mak WC(1), Cheng PP(2), Lau A(3), Yip LW (3), Chan YWY(1), Cheung SF(3)
Affiliation :
(1) Department of Pharmacy, YCH. (2) Central Nursing Department, YCH. (3) Department of Medicine, YCH.
Introduction :
Atrial fibrillation is the most common cardiac arrhythmia. Although not immediately life-threatening, it causes a five-fold increase in stroke and two-fold increase in death. Oral anticoagulant (OAC), such as Warfarin, reduces the risk of stroke by two-third and mortality by one-quarter when compared with control. Non-vitamin K antagonist oral anticoagulants (NOACs) are suitable alternatives to Warfarin. As recommended by international clinical guidelines, in order to use Warfarin or NOACs safely, patients should be educated on many important precautions, such as drug administration, alarming side effects, drug-drug interactions, and drug-food interactions. However, due to heavy staff workload in public hospitals, many geriatric patients did not receive adequate anticoagulant education before they were discharged home.
Objectives :
(1)To educate geriatric patients on OAC. (2)To provide post-discharge support. (3)To compare patients’ OAC knowledge before and after receiving this service. (4)To measure patients’ satisfaction after receiving this service.
Methodology :
Designated nurses were responsible for screening patients in wards. Patients who were newly prescribed with OAC would be recruited if they were aged 60 years or above, living at home in Tsuen Wan district, and mentally sound/carer available. Nurses would conduct a pre-counseling OAC knowledge questionnaire containing 10 questions before the patients were discharged. Then, a clinical pharmacist would provide OAC counseling to the patients. After the patients returned home, weekly home visit and OAC education would be provide by another team of nurses. Home visit nurses would conduct the post-counseling questionnaire 4 weeks after pharmacist counseling. Besides, an 8-week post-counseling phone satisfaction survey would also be carried out by trained staff.
Result & Outcome :
From February 2017 to December 2018, 134 patients completed the 4-week post-counseling questionnaire and 127 patients completed the satisfaction survey. The mean age of the patients was 75.3±7.39 years old and 59.7% of them were male. There was about 156% increase in patients’ OAC knowledge (baseline vs. 4-week mean out of 10 marks: 3.2±1.94 vs. 8.2±1.41, p<0.001). In the satisfaction survey, for the statement “overall, I am satisfied with the service”, patients gave a mean score of 4.83 out of 5. Moreover, the mean scores of patients’ satisfaction on pharmacists and nurses were 4.76 and 4.83 out of 5, respectively.
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