摘要
目的调查接受抗凝治疗的非瓣膜性心房颤动(房颤)患者对口服抗凝药(OAC)可能存在的顾虑,探究针对OAC进行科学宣教时需要强化教育的靶点。方法本研究为横断面调查研究。纳入2018年12月至2019年10月在南京医科大学第一附属医院心血管内科抗凝门诊接受OAC治疗的非瓣膜性房颤患者,进行问卷调查,评估患者对OAC的顾虑程度。问卷包含10个问题,患者针对每个问题给出不同的分值代表不同的顾虑程度。0~10分表示顾虑程度从无到非常严重,其中0~3分被认为有轻度顾虑,4~7分被认为有中度顾虑,8~10分被认为有重度顾虑。结果研究共纳入115例患者,其中男71例(61.7%,71/115),年龄(65.9±12.5)岁,CHA2DS2-VASc积分为(2.87±1.80)分。服用华法林56例(48.7%,56/115)、利伐沙班36例(31.3%,36/115)、达比加群酯23例(20.0%,23/115)。根据患者的医保性质将入组患者分为城市组(n=89)和农村组(n=26),两组患者OAC使用的种类差异无统计学意义(P=0.828)。相比城市组,农村组患者更担心服用OAC后出血风险[(4.1±3.6)分对(6.9±3.0)分,P=0.003]以及OAC过量后无拮抗剂的问题[(3.6±3.8)分对(5.8±3.7)分,P=0.039];而在药物费用方面,农村和城市两组间顾虑差异无统计学意义(P=0.349)。两组人群在OAC与其他药物(66.1%,76/115)或食物(42.6%,49/115)的相互作用问题上轻度顾虑比例更多,而在OAC对肝肾损害方面重度顾虑占比更高(36.5%,42/115)。结论目前接受OAC治疗的房颤患者在经济方面的顾虑较低,但对OAC仍缺乏正确的认知,总体患者对肝肾损害方面顾虑较重,而农村患者更担心服用OAC后出血风险,需进一步加强科学宣教以及院外监督以提高抗凝依从性。
Objective To assess the concerns about oral anticoagulants(OAC)in patients with nonvalvular atrial fibrillation(NAF)receiving anticoagulant therapy and find the education target in the use of OAC.Methods It was a cross-sectional study.From December 2018 to October 2019,patients with NAF receiving OAC treatment in Department of Cardiology,The First Affiliated Hospital of Nanjing Medical University were included.The questionnaire survey containing 10 questions was conducted to evaluate each patient's degree of concerns about OAC.A score of 0-10 indicated a level of concern ranging from none to very serious,with 0-3 considered as mild concern,4-7 considered as moderate concern,and 8-10 considered as serious concern.Results A total of 115 patients[mean age(65.9±12.5)years and 71 males]were selected in this study.The mean CHA2DS2-VASc score was 2.87±1.80.Fifty-six patients(48.7%,56/115)took warfarin,36 patients(31.3%,36/115)took rivaroxaban,and 23 patients(20.0%,23/115)took dabigatran.There were 89(77.4%,89/115)urban residents(urban group)and 26(22.6%,26/115)rural residents(rural group).It had no significant difference in the types of OAC between urban and rural groups(P=0.828).Compared to urban patients,rural patients were more concerned about the risk of bleeding(4.1±3.6 vs.6.9±3.0,P=0.003)and the absence of antagonist after OAC overdose(3.6±3.8 vs.5.8±3.7,P=0.039).There was no significant difference in drug cost between rural and urban population(P=0.349).Both of the two groups showed little concern about OAC's interaction with other drugs(66.1%,76/115)or food(42.6%,49/115),while much concern about the potential impairment of liver and kidney functions by OAC(36.5%,42/115).Conclusion Patients with NAF who received OAC treatment had little economic concerns.However,their knowledge of OAC remained lacking.Proper scientific education and optimized out-patient management of OAC should be further strengthened to improve the adherence to OAC.
作者
焦锦程
蒋浩
吴颖
沙子墨
麻舒扬
施姣姣
张杜枭
郦明芳
陈明龙
Jiao Jincheng;Jiang Hao;Wu Ying;Sha Zimo;Ma Shuyang;Shi Jiaojiao;Zhang Duxiao;Li Mingfang;Chen Minglong(Department of Cardiology,The First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital),Nanjing 210029,China;Department of Pharmacy,The First Affiliated Hospital of Nanjing Medical University(Jiangsu Province Hospital),Nanjing 210029,China)
出处
《中华心律失常学杂志》
2023年第4期335-340,共6页
Chinese Journal of Cardiac Arrhythmias
关键词
心房颤动
口服抗凝药
问卷调查
服药依从性
Atrial fibrillation
Oral anticoagulant
Questionnaire
Drug adherence
