75% of anticoagulation patients unaware their drug is used to prevent blood clots

Main Category: Cardiovascular / Cardiology
Article Date: 31 Aug 2004 - 13:00 PDT

email to a friend   printer friendly   opinions  

According to a new study, 75% of anticoagulation patients do not know their drug is used to prevent blood clots.

"It's About Time" campaign launched to promote greater understanding of thrombosis prevention

Results of a new pan-European survey, presented today, demonstrate a need for improved patient education and less cumbersome treatments to improve efficacy and quality of life amongst patients receiving long-term anticoagulant therapy.1 The survey, conducted with 711 patients receiving vitamin K antagonists (VKA) such as warfarin, marks the launch of It's About Time, a campaign led by the patient group AntiCoagulation Europe and key international physicians to promote greater understanding of thrombosis and stroke prevention and ultimately, to raise standards of care.

European Society of Cardiology Annual Congress, Munich, Germany

Although effective at preventing blood clots and stroke, VKAs are associated with extensive food and drug interactions and require careful management and regular coagulation monitoring to ensure the balance between efficacy and safety is achieved.

The survey,1 conducted amongst patients with atrial fibrillation (AF) - a condition which results in a six-fold increase risk of stroke2 - highlights the impact of the limitations of VKAs on patients' lives. 66 percent had to attend blood-monitoring sessions, typically at a hospital or clinic, at least once a month for the entire duration they had received therapy - which for those patients questioned, had been an average of six years, with one in ten patients having received treatment for 15 years or longer.1 Patients reported that their monitoring had a negative impact on their ability to hold down a job, go on holiday and spend time with their families.1 A worrying statistic showed that one in five patients had missed a blood monitoring appointment,1 placing them at an increased likelihood of falling outside their target treatment range, which is measured by INR - raising the risk of stroke and fatal bleeds.

In response to INR fluctuations, patients required dose changes following every fourth monitoring session, on average.1 Unsurprisingly, one in six patients have missed or forgotten to begin their new regime.1

This may also, in part, be explained by the finding over a third of patients believed their being 'out of range' had no major effect on their health.1

While a quarter of patients reported taking over the counter or herbal medicines in addition to their prescription drugs, only a third have informed their doctor of this - placing themselves at risk of negative VKA drug interaction and ineffective protection from stroke.1 Almost half of patients modified their diet to avoid food interactions with VKAs.1

Despite the crucial role patients are required to play in managing their own treatment, today's survey highlights a dearth in patient education. Only 25 percent of patients questioned on their anticoagulant treatment responded that their medication was used to prevent blood clots occurring.1 One in seven AF patients incorrectly thought that VKAs are used to correct their irregular heartbeat.1 Furthermore, a quarter failed to recall receiving any information on AF at their time of diagnosis, and, of those who did receive information, only one in three were provided with information about their treatment.1

"Without an understanding of what the drug does and how everyday actions can affect its efficacy, patients may unwittingly undermine the protection VKAs provide against stroke," comments Eve Knight, Chair, AntiCoagulation Europe. "It's About Time will bring together physicians and patient groups to urge for improved education and new treatment options to improve clinical outcomes and quality of life for patients receiving long-term anticoagulation."

Today's survey complements the Euro Heart Survey on Atrial Fibrillation of the European Society of Cardiology,3 a survey conducted by the ESC amongst cardiologists in 35 countries to identify attitudes towards, and opinions of, the management of anticoagulation in AF.

"The ESC is committed to improving standards of care for patients with AF and the Euro Heart Survey on Atrial Fibrillation will assist by identifying and sharing best practice," commented Professor Harry Crijns, Department of Cardiology, University Hospital of Maastricht, and lead investigator, Euro Heart Survey on Atrial Fibrillation. "We welcome the It's About Time campaign and the findings of today's patient survey, which will help to raise discussion to ensure that patients on long-term, anticoagulation are receiving the best care possible."

The 'It's About Time' patient survey is sponsored by an unrestricted educational grant from AstraZeneca.

-ends-

For further press information, please contact Elaine Ferguson or Mikhalia Berdy at Chandler Chicco Agency (+44 20 7318 8300; e.ferguson@cca-uk.com, m.berdy@cca-uk.com)

For further information about AntiCoagulation Europe please visit:
http://www.anticoagulationeurope.org

Notes to Editors

AntiCoagulation Europe is a charity providing information and advice to people on oral anticoagulation therapy. Their aim is to give support to all patients, their families and carers on all aspects of anticoagulation therapy, as well as fostering and encouraging communication and education on anticoagulation therapy.

Members of the It's About Time taskforce

-- Professor Giancarlo Agnelli: Professor of Internal Medicine, University of Perugia, Perugia, Italy

-- Professor Gregory YH Lip: Consultant Cardiologist, Honorary Professor of Cardiovascular Medicine, Director - Haemostasis Thrombosis & Vascular Biology Unit, University Department of Medicine, City Hospital, Birmingham, UK

-- Professor Giles Montalescot: Institute of Cardiology, Hôpital Pitié Salpétrière, Institut du Coeur, Paris, France

-- Dr Dan Rost: General Practitioner, Præstegårdsvej 5, DK-6070 Christiansfeld, Denmark

The It's About Time Patient Survey was conducted by Ipsos UK Limited, an independent market research company, through June and July 2004. 711 patients with atrial fibrillation receiving anticoagulation therapy were interviewed from seven countries across Europe (France, Germany, Italy, Norway, Spain, Sweden & the UK).

The International Normalised Ratio (INR) was established by the World Health Organization (WHO) and the International Committee on Thrombosis and Hemostasis for reporting the results of blood coagulation/clotting tests. All results are standardised using the international sensitivity index for the particular thromboplastin reagent and instrument combination utilised to perform the test.

The Euro Heart Survey (EHS) on Atrial Fibrillation is an initiative of the European Society of Cardiology (ESC), designed to assist in the understanding of the prevalence of cardiovascular diseases and differences in its diagnosis and treatment throughout ESC member countries. The EHS programme consists of a number of surveys into specific cardiovascular diseases, which aim to assess:

-- Existing clinical practice in relation to existing guidelines in cardiology

-- Applicability of results of major clinical trials

-- Outcome of different strategies for patient management

References

1 The It's About Time patient survey was carried out in seven European countries - France, Germany, Italy, Norway, Spain, Sweden & the UK, throughout June and July 2004. The research was carried out by Ipsos UK Ltd, an independent market research company.

2 Albers GW, Dalen JE, Laupacis A, Manning WJ, Petersen P, Singer DE. Antithrombotic therapy in atrial fibrillation. Chest 2001;119:194S-206S.

3 http://www.escardio.org

• Additional
• References
• Citations