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Large regional differences in prescription patterns of oral anticoagulants and knowledge of the disease and therapy among Polish patients with atrial fibrillation

Published on Feb 26, 2019in Kardiologia Polska1.674
· DOI :10.5603/KP.a2019.0036
Agnieszka Janion-Sadowska6
Estimated H-index: 6
(Jan Kochanowski University),
Marcin Sadowski9
Estimated H-index: 9
(Jan Kochanowski University)
+ 11 AuthorsAnetta Undas41
Estimated H-index: 41
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Abstract
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.
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Last. Anetta Undas (Jagiellonian University Medical College)H-Index: 41
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#1Gabriela Rusin (Jagiellonian University Medical College)H-Index: 1
#2Konieczyńska MH-Index: 5
Last. Anetta Undas (Jagiellonian University Medical College)H-Index: 41
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Abstract Background Oral anticoagulation (OAC) increases the bleeding risk. We investigated how clinical factors and the level of atrial fibrillation (AF) knowledge affect the bleeding acceptance in patients with AF. Methods In 173 consecutive anticoagulated outpatients with AF (aged 68.7±10.7 years, 39.3% male), the Bleeding Ratio was assessed based on the declared maximum number of major bleeds the people were willing to endure to avert one stroke. The Jessa AF Knowledge Questionnaire was used...
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