Factors that interfere with the quality of warfarin treatment in patients with atrial fibrillation in the real-world context
DOI:
https://doi.org/10.30968/jhphs.2025.162.1308Abstract
Objective: To characterize patients with atrial fibrillation (AF) treated at an anticoagulation clinic in Brazil who use warfarin and to identify factors associated with the quality of oral anticoagulation, measured by the Time in Therapeutic Range (TTR). Methods: Crosssectional study conducted between April and July 2019, involving patients with AF using warfarin under outpatient follow-up. The Mini-Mental State Examination (MMSE), the Short Assessment of Health Literacy for Portuguese-speaking Adults (SAHLPA-18), and the Oral Anticoagulation Knowledge (OAK) Test were applied. TTR was calculated based on the International Normalized Ratio (INR) and was considered adequate when ≥60%. Pharmacotherapy complexity was assessed using the Medication Regimen Complexity Index (MRCI). Data were analyzed using Student’s t-test, Chi-square or Fisher’s exact test, and logistic regression to calculate the odds ratio (OR). Results: The mean age of the 82 patients was 66.77 ± 9.54 years, with a predominance of males (52.44%). Most patients had low health literacy (75.58%) and 37.21% were using highly complex pharmacotherapies. Female sex and pharmacotherapy complexity were significantly associated with TTR < 60% (p < 0.05). Conclusion: The control of oral anticoagulation with warfarin may be influenced by factors such as sex and therapeutic complexity. Targeted interventions, including intensive pharmaceutical follow-up and educational strategies, may enhance therapeutic effectiveness in patients with AF.
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