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Research Article Open Access
Background: There are limited studies addressing patient's willingness to switch to a new anticoagulant from warfarin. The goal of this study was to determine the effect of patient knowledge and satisfaction with warfarin therapy on willingness to switch to a new oral anticoagulation therapy in an urban clinic. Methods: A cross-sectional study was conducted among warfarin-treated patients attending a pharmacist-run urban anticoagulation clinic at Howard University Hospital from August 2014-February 2015. The primary outcome evaluated was willingness to switch to a new oral anticoagulant. Other variables assessed include social demographics, clinic factors, patient knowledge and satisfaction. The modified anti-clot treatment survey (ACTS), the oral anticoagulant knowledge survey (OAKS), and a validated willingness to switch survey were used to measure patient knowledge (high ≥ 75%), satisfaction (Likert scale ≥ 4) and willingness to switch (Likert scale ≥ 4), respectively. Statistical analysis was conducted using (Statistical Package for the Social Sciences (SPSS) version 22.0. Results: A total of 100 patients on warfarin treatment were included. The majority of participants were retired/disabled (59%), mostly African American (86%), and male (55%). The mean willingness to switch score was 21.59 (out of 35). Patients were most willing to switch to an alternative agent which required less follow up (3.55 ± 1.77) and had fewer drug interactions (3.75 ± 1.67). Factors associated with willingness to switch varied based on patient preferences. The only predictor of willingness to switch was low satisfaction (p=0.002). Knowledge was not associated with willingness to switch (p=0.249). Conclusion: Patients in an anticoagulation clinic had low knowledge of their warfarin therapy, were overall satisfied with warfarin treatment, but were willing to consider using a new oral anticoagulant that was more convenient especially if low satisfaction with warfarin. Further studies should be directed toward patient preferences in determining optimal regimen.
Warfarin, Willingness to switch, New oral anticoagulants, Patient satisfaction, Patient knowledge, Health Care, Health service