Why the study?
The study aimed to investigate the accuracy of self-reported adherence and the relationship between adherence to warfarin, demographic and clinical variables, and treatment satisfaction in stroke patients.
In stroke patients on warfarin, self-reported adherence using the MTA scale demonstrates good sensitivity but poor specificity compared to objective INR levels, despite high patient satisfaction.
MTA's low specificity warrants caution for adherence monitoring in warfarin-treated stroke patients; leaves open need for validated tools against objective INR.
AIM: The aim of this study was to investigate the accuracy of the self-reported measure of adherence and the relation between adherence to warfarin use, demographic and clinical variables, and the satisfaction with the treatment in patients affected by stroke. METHODS: This is a correlational, quantitative, and cross-sectional study, carried out in the outpatient clinics of a public university hospital from October 2017 to April 2018. Sociodemographic and clinical data were collected through interviews and hospital charts, as well as by applying the Measurement of Treatment Adherence (MTA) and the Duke Anticoagulation Satisfaction Scale, in their Brazilian versions. Results of the international normalized ratio (INR) were collected. Measurements of accuracy of the MTA scale were calculated in relation to the INR classification. RESULTS: Of 99 patients (55.6% male with a mean age of 58.6 years), 57.6% presented with therapeutic INR values and 75.8% of the patients were adherent to the oral anticoagulant therapy according to the MTA. The accuracy analysis of the measurement provided by the MTA scale in relation to the INR classification showed a sensitivity of 77.2% and a specificity of 26.2%. The patients' satisfaction with the treatment was high. The Duke Anticoagulation Satisfaction Scale had an average total score of 46.4, with the dimension impact in the field having the highest score (20.3). CONCLUSION: Stroke patients were adherent and satisfied with the oral anticoagulant therapy. The MTA had good sensitivity and poor specificity. Sociodemographic and clinical characteristics identified were not associated with adherence and satisfaction with treatment.
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Oliveira et al. (2019) studied this question.
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