Satisfaction with Warfarin Therapy and It’s Relation with International Normalized Ratio Monitoring

Background: Use of oral anticoagulant therapy (OAT) has been associated with reduction in morbidity and mortality of thromboembolic complications. The use of vitamin K antagonist is effective in the prevention of thromboembolic complications. However, its use also implies lifestyle modifications and change in the behavior which may affect in a negative way patient's quality of life. Warfarin is the most frequently used oral anticoagulant. Satisfaction was associated significantly with better control of INR, which in turn is critical in evolving educational interventions for a better patient care. Treatment with warfarin requires proper and regular monitoring to prevent the thromboembolic complications as well as to prevent over anticoagulation state. This study aimed to assess satisfaction level among warfarin patients as well as to evaluate factors influencing their level of satisfaction. Methods: A prospective observational cross-sectional study was conducted on 133 patients during a period of six weeks: (from 24th of December 2018 till 29th of January 2019) at the Anticoagulation Clinic at Queen Alia Heart Institute, who were on warfarin therapy using the validated Anti-Clot Treatment Scale (ACTS). Results: Among 133 patients who completed the questionnaire, the majority of patients (52.63%) were considered dissatisfied with their treatment with total frequency of seventy patients, while fifty five patients (41.35%) were considered satisfied with it. Female patients, those who live outside Amman, and patients who experienced a previous bleeding episode, were more dissatisfied with their treatment. While Non-smoker patients, and those who have a higher monthly income were more satisfied with their treatment. Conclusion: This observational study called for urgent strategies to improve the satisfaction degree in warfarin patients; one of the factors that are important determinant of better INR control. Thus, it is a must to apply methods of best practice to enhance the satisfaction by the following probable solutions; opening anticoagulant clinics in peripheral hospitals provided with clinical pharmacist as well as dietitian in order to reduce the burden on patients to visit the capital city, maintenance and monitoring the (INR) to be within the optimal therapeutic target range in order to reduce the possibility of bleeding episodes, and encourage the patients who are smoking to quit it at every possible visit to the clinic.