Evaluation of patients knowledge on warfarin and counselling effectiveness among warfarin clinic patients of Pusat Perubatan Universiti Kebangsaan Malaysia

Introduction: Warfarin is an oral anticoagulant that is widely used for patients with risk of forming blood clots. Even though Warfarin is effective in preventing blood coagulation, it has a narrow therapeutic index. Close monitoring and dose adjustments is needed to ensure a therapeutically INR can be achieved. Warfarin is known to have numerous drug-drug interactions and drug-food interactions that may affect the safety and efficacy of treatment. To prevent adverse drug reactions, sufficient knowledge should be obtained by patients.

Objectives: The objectives of this study are to assess the level of knowledge among patients through questionnaires, to assess the efficiency of warfarin counseling given to the patients by pharmacy staffs and to investigate whether doctors and pharmacists play their role in doing the warfarin counseling to the patients.

Method: In this study, 102 patients that were attending Warfarin Clinic from September 2017 to January 2018 at Pusat Perubatan Universiti Kebangsaan Malaysia were interviewed and assessed using a questionnaire that was constructed based on booklet that was given to all Warfarin patients. The responses of the patients for the 10 questions questionnaire are then recorded.

Results: This study found out that the mean score of the warfarin patients is 5.91 with the standard deviation of 2.07533. A majority of 56 patients (54.9%) received counselling from pharmacists while 37 patients (36.3%) received counselling from doctors and the rest claimed to have never received counselling. Furthermore, 37.3% of the respondents gained a score lower than 5 and 39.2% of respondents gained a score higher than 7. Last but not least, age, race, education level and marital status was identified as factor affecting knowledge score but gender, employment status, duration of warfarin therapy, ownership of warfarin book and previous counselling was identified as having no significant over knowledge score gained.

Conclusion: As a conclusion, warfarin patients of Pusat Perubatan Universiti Kebangsaan Malaysia managed to generate a mean score of 5.91 ± 2.08. This score is slightly under 60% correct answers that are considered as satisfying score by other studies. Other than that, this stud confirmed that questionnaire can be used to assess patients’ knowledge. On the other hand, pharmacy staffs have study new method to ensure efficiency of counselling. Last but not least, doctors and pharmacists are found to work together to ensure safe and effective warfarin therapy.