J Chest Surg.  2021 Feb;54(1):25-30. 10.5090/kjtcs.20.106.

Effects of a Personalized Nurse-Led Educational Program for New Patients Receiving Oral Anticoagulant Therapy after Mechanical Heart Valve Prosthesis Implantation on Adherence to Treatment

• Eltheni R
• Schizas N
• Michopanou N
• Fildissis G

• KMID: 2512654
• DOI: http://doi.org/10.5090/kjtcs.20.106

Abstract

Background
Life-long anticoagulant therapy is mandatory for patients who undergo heart valve replacement with implantation of a mechanical prosthesis. The aim of this study was to investigate the effects of a nurse-led patient educational program concerning oral anticoagulant therapy intake after heart valve replacement surgery on patients’ knowledge of important parameters of anticoagulant administration.
Methods
In this single-center study, 200 patients who underwent surgical implantation of a mechanical prosthesis were divided into 2 groups. The control group received the basic education concerning oral anticoagulants, while the intervention group received a personalized educational program.
Results
Personalized education was correlated with a better regulation of therapeutic international normalized ratio (INR) levels and adequate knowledge among patients. Therapeutic levels of INR were achieved in 45% of the patients during the first month, 71% in the third month, and 89% in the sixth month after discharge in the intervention group, compared to 25%, 47%, and 76% in the control group, respectively. Patients’ satisfaction with the information was higher in the intervention group than in the control group. The percentage of satisfaction reached 80% for the intervention group versus 37% for the patients of the control group.
Conclusion
The implementation of the nurse-led educational programs was associated with improved clinical results and increased adherence to oral anticoagulant treatment.

Keyword

Personalized education; Oral anticoagulant therapy; Mechanical heart valve; Anticoagulation Knowledge Assessment Questionnaire; Patients’ information