Distribution characteristics and factors influencing oral warfarin adherence in patients after heart valve replacement.
Distribution characteristics and factors influencing oral warfarin adherence in patients after heart valve replacement.
复制标题
心脏瓣膜置换术后患者口服华法林的分布特征及影响因素。
DOI：
10.2147/ppa.s172223
复制
发表时间：
2018
影响因子：
2.2
通讯作者：
Liu J
中科院分区：
文献类型：
--
作者：
Wang X;Xu B;Liang H;Jiang S;Tan H;Wang X;Wang X;Yu S;Liu J
口服华法林抗凝是心脏瓣膜置换术后需要的长期治疗。这种治疗方法可以预防血栓等严重并发症，从而提高患者的术后存活率和生活质量。对人工机械瓣膜置换术患者在术后不同时间进行电话随访，是预防术后口服华法林抗凝相关事故的有效方法。我们的目标是确定一种方法，为心脏瓣膜置换术后口服华法林抗凝的患者提供理论指导。这项研究的参与者是接受人工机械瓣膜置换术的患者，并在术后进行了2年的随访。计算患者对医嘱的依从性，比较不同性别、不同年龄、不同地区、不同文化程度患者对处方时间、处方剂量、定期临床随访依从性的分布特征。采用单因素和多因素Logistic回归分析评价影响依从性的因素。我们的分析表明，心脏瓣膜置换术后患者对口服华法林抗凝的依从性受性别、年龄、居住地点和教育程度的影响。患者的用药习惯可以通过电话随访进行相应的评估。因此，可以提供剂量调整建议，显著提高心脏瓣膜置换术后患者对口服华法林抗凝的依从性。心脏瓣膜置换术后患者对口服华法林抗凝的依从性受性别、年龄、居住类型和教育水平以及电话临床随访的坚持程度的影响。后续会议有助于建立良好的医患沟通，这对于及时用药指导至关重要，从而缩短用药延误和缩短治疗总时长。
Oral warfarin anticoagulation is a long-term treatment that is required after heart valve replacement. This treatment can prevent serious complications, such as embolism, thereby increasing patients’ postoperative survival rates and quality of life. Patients treated with artificial mechanical heart valve replacement were followed up over the phone at different times after the procedure, which is an effective method for preventing accidents related to postoperative oral warfarin anticoagulation. Our goal was to determine a method for providing theoretical guidance to patients on oral warfarin anticoagulation following heart valve replacement. The participants of this study were patients who received artificial mechanical heart valve replacements and were followed up for 2 years after the procedure. Patient adherence to medical advice was calculated, and the distribution characteristics of adherence to prescribed timing, prescribed dose, and regular clinical follow-up among patients of both sexes and of different ages, regions, and educational levels attained were compared. Univariate and multifactorial logistic regression analyses were used to evaluate the factors influencing adherence. Our analyses showed that adherence to oral warfarin anticoagulation in patients after heart valve replacement is influenced by sex, age, residential location, and educational attainment. The medication habits of patients can be evaluated accordingly via phone follow-up. As such, dose adjustment recommendations can be provided, significantly increasing the adherence to oral warfarin anticoagulation in patients after heart valve replacement. Adherence to oral warfarin anticoagulation among patients after heart valve replacement is affected by sex, age, type of residence, and educational level, as well as adherence to clinical follow-up over the phone. The follow-up sessions help establish good doctor–patient communication, which is critical for timely medication guidance, thus shortening medication administration delays and decreasing the overall length of therapy.