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Effects of a Personalized Nurse-Led Educational Program for New Patients Receiving Oral Anticoagulant Therapy after Mechanical Heart Valve Prosthesis Implantation on Adherence to Treatment

Eltheni Rokeia, Schizas Nikolaos, Michopanou Nektaria, Fildissis Georgios,
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 ( Eltheni Rokeia ) - Evangelismos General Hospital of Athens Cardiac Surgery Intensive Care Unit
 ( Schizas Nikolaos ) - Evangelismos General Hospital of Athens Cardiac Surgery Intensive Care Unit
 ( Michopanou Nektaria ) - Evangelismos General Hospital of Athens Cardiac Surgery Intensive Care Unit
 ( Fildissis Georgios ) - National and Kapodistrian University of Athens School of Healthcare Sciences Faculy of Nursing

Abstract


Background: Life-long anticoagulant therapy is mandatory for patients who undergo heart valve replacement with implantation of a mechanical prosthesis. The aim of this study was to investigate the effects of a nurse-led patient educational program concerning oral anticoagulant therapy intake after heart valve replacement surgery on patients’ knowledge of important parameters of anticoagulant administration.

Methods: In this single-center study, 200 patients who underwent surgical implantation of a mechanical prosthesis were divided into 2 groups. The control group received the basic education concerning oral anticoagulants, while the intervention group received a personalized educational program.

Results: Personalized education was correlated with a better regulation of therapeutic international normalized ratio (INR) levels and adequate knowledge among patients. Therapeutic levels of INR were achieved in 45% of the patients during the first month, 71% in the third month, and 89% in the sixth month after discharge in the intervention group, compared to 25%, 47%, and 76% in the control group, respectively. Patients’ satisfaction with the information was higher in the intervention group than in the control group. The percentage of satisfaction reached 80% for the intervention group versus 37% for the patients of the control group.

Conclusion: The implementation of the nurse-led educational programs was associated with improved clinical results and increased adherence to oral anticoagulant treatment.

키워드

Personalized education; Oral anticoagulant therapy; Mechanical heart valve; Anticoagulation Knowledge Assessment Questionnaire; Patients’ information

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