Large regional differences in prescription patterns of oral anticoagulants and knowledge of the disease and therapy among Polish patients with atrial fibrillation
Background: The Jessa AF Knowledge Questionnaire (JAKQ) was successfully used to assess knowledge gaps in patients with atrial fibrillation (AF) . Aim: To evaluate regional differences in the patient awareness considering AF diagnosis and oral anticoagulation use in Poland. Methods: A total of 1583 patients with AF at a median age of 72 (IQR 66-79) years completed the JAKQ in three cardiology centres (centre I Krakow, centre II Torun, centre III Kielce) from January 2017 to June 2018. The final analysis included 1525 subjects, including 32.9% s on vitamin K antagonists (VKA) and 67.1% on non-VKA oral anticoagulants (NOAC), i.e. rivaroxaban and dabigatran (28.9% each), and apixaban (9.3%). Results: The mean score on the JAKQ was 55.5±18.4% with better results among patients on VKA compared with NOAC (58±18.3% vs. 54.3±18.4%, p=0.0002) with time from AF diagnosis more than 12 months (57.4±17.5% vs. 50±19.9%, p<0.0001). There was a significant difference in the knowledge scores between the three centres (I 59.5% vs. II 48.5% vs. III 54.3%, p<0.0001). In all centres the number of correct answers correlated inversely with patient’s age (r=-0.20, p< 0.0001). NOAC were more frequently used in centre III. The percentage of correct responses was lower in subjects on reduced NOAC doses (35.4% of the NOAC patients), compared with the full–dose NOAC group, in centre I (56.9% vs. 62.5%, p=0.012) and II (48.1% vs. 56.2%, p=0.003). Conclusions: Patients from a high-volume academic centre showed better knowledge than their counterparts from district hospitals. There are large regional differences in prescription patterns of oral anticoagulants, including the preferred NOAC.