Knowledge of Non-Vitamin K Antagonist Oral Anticoagulants and Associated Factors Among Patients with Atrial Fibrillation: A Cross-Sectional Study in Thailand

Background/Objectives: Adequate patient knowledge of non-vitamin K antagonist oral anticoagulants (NOACs) is important for their safe and effective use in atrial fibrillation (AF), yet knowledge deficits remain widely reported. This study assessed NOAC knowledge and identified factors associated with knowledge level among Thai AF outpatients at a tertiary cardiac center. Methods: A cross-sectional study was conducted between January and March 2023 using the KAQNAF-Thai, a validated 23-item instrument covering six domains, classified as high (≥60%) or low (<60%). Factors associated with low knowledge were identified using multivariable logistic regression. Results: A total of 250 participants were enrolled (mean age 71.9 ± 9.13 years; 53.2% male). The mean total knowledge score was 15.4 ± 3.04 out of 23 points (67% correct responses), with 178 (71.2%) having high knowledge and 72 (28.8%) having low knowledge. The most critical gaps were in laboratory monitoring (correct response rate 36.0%) and dose management; accidental double dosing (13.2%), NOAC effectiveness after vomiting (30.4%), and missed dose management (34.4%). Three variables were independently associated with low knowledge: age ≥75 years (aOR = 2.11 [95% CI 1.10–4.05]), education below tertiary level (aOR = 17.38 [95% CI 5.03–60.01]), and lack of awareness of NOAC indications (aOR = 3.22 [95% CI 1.25–8.29]). Conclusions: Although most Thai AF patients met the threshold for high NOAC knowledge, critical gaps in laboratory monitoring and dose management persisted even in this group. Educational interventions should prioritise elderly patients, those with lower educational attainment, and those unaware of their NOAC indication.