Patient education and oral anticoagulant therapy

Abstract BACKGROUND AND OBJECTIVE: The educational aspect of oral anticoagulant treatment is considered a possible cause of variability in anticoagulation levels. The aim of this prospective study was to investigate whether the time spent in the therapeutic range (TSTR) by patients taking oral anticoagulants could be improved by two different, consecutive educational approaches on the crucial aspects of oral anticoagulant therapy. DESIGN AND METHODS: Between May and June 2004, validated interviews were conducted with 240 patients (128 male and 112 female, mean age 50 +/- 12 years) enrolled in the study. Three months later, the patients were randomly allocated to three groups. A course that focused on the questions in the interview was followed by the first group (n = 80); a brochure containing the correct answers to questions was given to the second (n = 81); nothing was provided for the third (n = 79). RESULTS: A significant difference was found in the TSTR between the quarters preceding and following the interview. Mean TSTR increase was 13%. Patients that were randomly selected to attend the educational course, read a brochure or do nothing showed similar TSTR percentages in the quarter following the interview. A good control of the anticoagulant therapy (TSTR >70%) was maintained, with no significant variation during the following three-quarters. INTERPRETATION AND CONCLUSIONS: A two-step educational approach for patients on long-term oral anticoagulation does not improve TSTR percentages in the short term