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Title: | Minor bleeding affects the level of knowledge in patients with atrial fibrillation on oral anticoagulant therapy | Authors: | Metzgier-Gumiela, Agnieszka Skonieczny, Grzegorz Konieczynska, Malgorzata DESTEGHE, Lien HEIDBUCHEL, Hein Undas, Anetta |
Issue Date: | 2020 | Publisher: | WILEY | Source: | International Journal of Clinical Practice, 74 (6) (Art N° e13483) | Abstract: | Background Anticoagulant therapy in patients with atrial fibrillation (AF) increases the risk of minor bleeding, which is mostly accepted by patients. We aimed to assess whether continuation of anticoagulation despite minor bleeding is associated with a higher level of knowledge on AF and anticoagulation. Methods and results In 1525 patients with AF on oral anticoagulation who completed the Jessa AF Knowledge Questionnaire (JAKQ) (median age: 72 years [range, 65-79 years]; men: 54.6%), persistent self-reported minor bleeding was recorded. Minor bleeding was observed in 567 patients (37.2%) including 224 patients (39.5%) on vitamin K antagonists (VKAs) and 343 (60.5%) on non-vitamin K antagonist oral anticoagulants (NOACs). The risk of minor bleeding was lower among patients on NOACs than on VKAs (33.5% vs 44.6%; P < .0001). Multiple logistic regression showed that minor bleeding was associated with the use of NOACs (odds ratio [OR] 0.75; 95% CI 0.59-0.97), female gender (OR 2.19; 95% CI, 1.74-2.75; P < .0001), history of major bleeding (OR 2.85; 95% CI, 1.96-4.14; P < .0001), time since AF diagnosis (OR 1.04; 95% CI, 1.01-1.06; P < .0001), concomitant vascular disease (OR 1.43; 95% CI, 1.10-1.87; P = .0008) and diabetes mellitus (OR 1.3; 95% CI, 1.02-1.65, P = .03). Patients with minor bleeding, compared with the remaining subjects scored higher on the JAKQ (median, 62.5% vs 56.2%, respectively, P < .0001). The former group knew more about the purpose of anticoagulant therapy (71.8% vs 65.7%, P = .01) and bleeding as its key side effect (66.1% vs 52.7%, P < .0001), and were better informed on the safest painkillers to use in combination with anticoagulation (48% vs 35%, P < .0001). Conclusion This study suggests that AF patients who accept persistent minor bleeding have better knowledge on the disease and anticoagulation therapy compared with those free of these side effects. | Notes: | Undas, A (reprint author), Jagiellonian Univ, Inst Cardiol, Med Coll, Ul Pradnicka 80, PL-31202 Krakow, Poland. mmundas@cyf-kr.edu.pl |
Other: | Undas, A (reprint author), Jagiellonian Univ, Inst Cardiol, Med Coll, Ul Pradnicka 80, PL-31202 Krakow, Poland. mmundas@cyf-kr.edu.pl | Keywords: | atrial fibrillation;knowledge;minor bleeding;non-vitamin K antagonist oral anticoagulants;questionnaire;vitamin K antagonists | Document URI: | http://hdl.handle.net/1942/30705 | ISSN: | 1368-5031 | e-ISSN: | 1742-1241 | DOI: | 10.1111/ijcp.13483 | ISI #: | WOS:000512422000001 | Rights: | 2020 John Wiley & Sons Ltd | Category: | A1 | Type: | Journal Contribution | Validations: | ecoom 2021 |
Appears in Collections: | Research publications |
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