TRial of an Educational intervention on patients' knowledge of Atrial fibrillation and anticoagulant therapy, INR control, and outcome of Treatment with warfarin (TREAT)
Open accessAbstract
BACKGROUND: Atrial fibrillation (AF) patients with a high risk of stroke are recommended anticoagulation with warfarin. However, the benefit of warfarin is dependent upon time spent within the target therapeutic range (TTR) of their international normalised ratio (INR) (2.0 to 3.0). AF patients possess limited knowledge of their disease and warfarin treatment and this can impact on INR control. Education can improve patients' understanding of warfarin therapy and factors which affect INR control. METHODS/DESIGN: Randomised controlled trial of an intensive educational intervention will consist of group sessions (between 2-8 patients) containing standardised information about the risks and benefits associated with OAC therapy, lifestyle interactions and the importance of monitoring and control of their International Normalised Ratio (INR). Information will be presented within an 'expert-patient' focussed DVD, revised educational booklet and patient worksheets. 200 warfarin-naïve patients who are eligible for warfarin will be randomised to either the intervention or usual care groups. All patients must have ECG-documented AF and be eligible for warfarin (according to the NICE AF guidelines). Exclusion criteria include: aged < 18 years old, contraindication(s) to warfarin, history of warfarin USE, valvular heart disease, cognitive impairment, are unable to speak/read English and disease likely to cause death within 12 months. Primary endpoint is time spent in TTR. Secondary endpoints include measures of quality of life (AF-QoL-18), anxiety and depression (HADS), knowledge of AF and anticoagulation, beliefs about medication (BMQ) and illness representations (IPQ-R). Clinical outcomes, including bleeding, stroke and interruption to anticoagulation will be recorded. All outcome measures will be assessed at baseline and 1, 2, 6 and 12 months post-intervention. DISCUSSION: More data is needed on the clinical benefit of educational intervention with AF patients receiving warfarin. TRIAL REGISTRATION: ISRCTN93952605.
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Several patient-information tools have been developed, largely focusing on oral anticoagulation.
“Several patient-information tools have been developed, largely focusing on oral anticoagulation.[1013][1014][1015][1016]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [1015]
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- Authors
- Smith, D. E., Xuereb, C. B., Pattison, H. M., Lip, G. Y., & Lane, D. A.
- Affiliations
- Aston University (GB)
- Corresponding author
- Lane, Deirdre A
- Venue
- BMC Cardiovascular Disorders
- Published
- 2010-05-20
- Volume
- 10
- Issue
- 1
- Pages
- 21-21
- ISSN
- 1471-2261 (ISSN-L)
- PMC
- PMC2887377
- OpenAlex
- W2127058406
- Cited by
- 42
- References
- 23
- Citations by year
- 2026: 1 · 2025: 1 · 2024: 2 · 2023: 1 · 2022: 1 · 2021: 3 · 2020: 1 · 2019: 4 · 2018: 3 · 2017: 2 · 2016: 7 · 2015: 4 · 2013: 5
- FWCI
- 2.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Cardiovascular Disorders (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Aston Publications Explorer (Aston University) (acceptedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion, cc-by)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Life Sciences › Pharmacology, Toxicology and Pharmaceutics › Pharmacology › Pharmacy and Medical Practices
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Health and Mental Health
- Keywords
- atrial fibrillation, warfarin, anticoagulation, patient education, international normalized ratio, stroke prevention, patient knowledge, illness representations, medication beliefs, quality of life, bleeding complications, educational intervention
- MeSH terms
- Anticoagulants, Atrial Fibrillation, Costs and Cost Analysis, Follow-Up Studies, United Kingdom, Humans, Patient Education as Topic, Socioeconomic Factors, Warfarin, Treatment Outcome, Disease Progression, International Normalized Ratio
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