Alarming lack of knowledge about antithrombotic therapy among patients with atrial fibrillation

ABSTRACT

Large population campaigns have been conducted in Brazil to improve knowledge about the signs and symptoms of stroke and the importance of time to care.

Objective: Parallel to these important actions, we aimed to evaluate the lay knowledge of patients with atrial fibrillation, a well-recognized etiology of stroke, adequate treatment and management of which can prevent up to 30% of cerebrovascular events.

Methods: We questioned 143 patients with atrial fibrillation about the risks associated with the disease.

Results: Ninety-one percent were on anticoagulation treatment. Of the total, 63.6% reported having been informed about the risks and benefits of anticoagulants but only 46.9% were able to correctly mention one of these risks. Ischemic stroke was identified as a risk by only 25.9% and hemorrhagic stroke was not mentioned. A CHADS₂ ≥ 2 was scored by 84.0% of the patients.

Conclusions: Our study showed an alarming knowledge gap in patients with atrial fibrillation. Difficulty in adherence to treatment resulting from the failure of this communication is possibly one of the factors responsible for the high incidence and recurrence of stroke, and should not go unnoticed.

RESUMO

Campanhas populacionais para melhorar o conhecimento sobre os sinais e sintomas do acidente vascular encefálico e a importância do tempo para o tratamento têm sido realizadas no nosso país, visando a melhoria da linha do atendimento.

Objetivo: Paralelamente a estas relevantes ações, objetivamos avaliar o conhecimento leigo de pacientes portadores de fibrilação atrial, etiologia determinada e prevalente do acidente vascular encefálico, cujo tratamento e manejo adequado podem prevenir até 30% dos eventos cerebrovasculares.

Métodos: Entrevistamos portadores de fibrilação atrial sobre os riscos associados à doença.

Resultados: Noventa e um por cento estavam sob uso de anticoagulantes. Do total, 63,6% responderam terem sido informados sobre riscos e benefícios da terapia anticoagulante, mas apenas 46,9% souberam citar corretamente um desses riscos. Acidente vascular encefálico isquêmico foi associado ao risco por apenas 25,9% e acidente vascular encefálico hemorrágico não foi mencionado. CHADS₂ ≥ 2 foi pontuado por 84,0% dos pacientes.

Conclusões: Nosso estudo demonstra uma alarmante falha no conhecimento do risco de acidente vascular encefálico nos portadores de fibrilação atrial. Dificuldade na aderência ao tratamento resultante da falha dessa comunicação é fator relevante na incidência e recorrência do acidente vascular encefálico e não deve ser negligenciado.

Keywords:

Atrial fibrillation - stroke - patient medication knowledge - warfarin - anticoagulants

Palavras-chave:

fibrilação atrial - acidente vascular cerebral - conhecimento do paciente sobre a medicação - varfarina - anticoagulantes

Publication History

Received: 04 April 2018

Accepted: 27 August 2018

Article published online:
22 August 2023

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