Key result
A personalized nurse-led educational program significantly increased the proportion of patients achieving therapeutic INR levels at 6 months compared to standard education (89% vs 76%, p=0.014).
Why the study?
Lifelong anticoagulant therapy is mandatory following mechanical heart valve prosthesis implantation, and the study investigated the effects of a nurse-led educational program on patients' knowledge regarding oral anticoagulant intake.
Does a personalized nurse-led educational program improve adherence to oral anticoagulant therapy and knowledge in patients after mechanical heart valve prosthesis implantation?
Does a personalized nurse-led educational program improve adherence to oral anticoagulant therapy and knowledge in patients after mechanical heart valve prosthesis implantation?
Absolute Event Rate: 89% vs 76%
p-value: p=0.014
A personalized nurse-led educational program significantly improves therapeutic INR control, patient knowledge, and satisfaction while reducing hemorrhagic complications in patients receiving oral anticoagulation after mechanical heart valve replacement.
May support nurse-led education to improve INR control and reduce bleeding after mechanical valves; leaves open need for randomized confirmation.
BACKGROUND: Life-long anticoagulant therapy is mandatory for patients who undergo heart valve replacement with implantation of a mechanical prosthesis. The aim of this study was to investigate the effects of a nurse-led patient educational program concerning oral anticoagulant therapy intake after heart valve replacement surgery on patients' knowledge of important parameters of anticoagulant administration. METHODS: In this single-center study, 200 patients who underwent surgical implantation of a mechanical prosthesis were divided into 2 groups. The control group received the basic education concerning oral anticoagulants, while the intervention group received a personalized educational program. RESULTS: Personalized education was correlated with a better regulation of therapeutic international normalized ratio (INR) levels and adequate knowledge among patients. Therapeutic levels of INR were achieved in 45% of the patients during the first month, 71% in the third month, and 89% in the sixth month after discharge in the intervention group, compared to 25%, 47%, and 76% in the control group, respectively. Patients' satisfaction with the information was higher in the intervention group than in the control group. The percentage of satisfaction reached 80% for the intervention group versus 37% for the patients of the control group. CONCLUSION: The implementation of the nurse-led educational programs was associated with improved clinical results and increased adherence to oral anticoagulant treatment.
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Eltheni et al. (2021) studied Mechanical heart valve prosthesis requiring oral anticoagulant therapy (n=200). Personalized nurse-led educational program vs. Standard basic education was evaluated on Achievement of therapeutic INR levels at 6 months (p=0.014). A personalized nurse-led educational program significantly increased the proportion of patients achieving therapeutic INR levels at 6 months compared to standard education (89% vs 76%, p=0.014).
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