Abstract

Dr. Sakina I. Mamdani*, David G. Nyamu and Tom B. Menge

ABSTRACT

Background: Warfarin is widely used for long-term anticoagulation management in low resource health settings but it has a narrow therapeutic index. Patients’ knowledge on warfarin use promotes optimal anticoagulation and adherence. Objective: To evaluate the effect of a designed warfarin based patient education program on oral anticoagulation knowledge, adherence and level of control among adult outpatients on warfarin therapy at Kenyatta National Hospital. Methodology: A pre-test/post-test single group quasi study. Participants: forty-five outpatients aged ? 18 years at anticoagulation clinics. Main outcome measures: Level of knowledge, adherence and anticoagulation control. Methods: Ethical approvals were sought from institutional review board (reference KNH/ERC/A/151) and study sites. Eligible participants were enrolled during clinic appointments. A predesigned data collection tool was used to collect information on sociodemographics, baseline oral anticoagulation knowledge, adherence and the most recent international normalized ratios, after which a designed warfarin based education program was provided to participants. Patients were given a warfarin education booklet for further reference.The effect of the designed education program on knowledge of anticoagulation, level of adherence and anticoagulation control was assessed thirty days post the intervention using the the same tools administered at baseline data. Data was analyzed using Statistical Package for Social Sciences version 21 software at 95% confidence level. Results: The mean participants’ age was 42.9(±13.7) years and majority were females (86.7%). There was a significant improvement between the pre-test and post-test anticoagulation knowledge mean scores (p