Why the study?
Patients with mechanical heart valves require lifelong anticoagulation and INR control, but improper management can cause life-threatening bleeding risks.
Does self-care training and information support improve INR control and reduce bleeding complications in patients with mechanical heart valves?
Does self-care training and information support improve INR control and reduce bleeding complications in patients with mechanical heart valves?
Self-care training and information support significantly improve the maintenance of therapeutic INR levels in patients with mechanical heart valves, though without a statistically significant reduction in bleeding complications over 6 months.
Self-care training may improve INR control after mechanical valve replacement; leaves open need for larger RCTs to confirm bleeding benefit.
Abstract BackgroundPatients with mechanical heart valve due to the possibility of coagulation complications require lifelong use of anticoagulants and International Normalized Ratio (INR) control. But if not taken care of properly, anticoagulant therapy itself can put people at risk for bleeding and be life-threatening. ObjectivesThe aim of this study was to determine the effect of Self-care training and information support of patients with mechanical heart valve on INR and the bleeding complications.DesignA randomized double-blind controlled trial.Settings and MethodsParticipants were recruited via convenience sampling from Farshchian hospital in Hamadan, Iran; and were randomly divided into two groups control (n=80) and intervention (n=80). Participants in the control group received only routine training; in addition, the intervention group received 6 sessions of self-care training and 6 months of information support. Monthly the level of INR and incidence of bleeding were determined. Data were analyzed using independent t-test and chi-square in spss16 software at a significance level of 0.05.ResultsDuring 6 months of follow-up, except for the third month, the frequency of INR levels in therapeutic target range (2.5-3.5) in the intervention group was significantly higher than the control group (p<0.05). Also in the intervention group, the incidence of bleeding complications was relatively less than the control group, but this difference was not statistically significant (p>0.05).ConclusionProper self-care training and information support in patients with mechanical heart valve replacement have positive results. By doing self-care, the level of a therapeutic target range of INR maintained and the incidence of bleeding complications can be reduced.
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Zandi et al. (2020) studied this question.
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