Outcome of home visit in uncontrolled INR patients taking warfarin in Khonsawan District Chaiyaphum Province

Abstract

Introduction: Warfarin is an oral anticoagulant with indications for the treatment and prevention of blood clots in blood vessels. This medicine carries a high risk, narrow therapeutic index. Incorrect medication or improper practices during medicine use may affect the treatment and cause adverse reactions from medication.

Objectives: To study medication problems, knowledge about warfarin use as well as study the results of home visits of warfarin-medicated patients who received the services of Warfarin Clinic at Khonsawan Hospital, Chaiyaphum Province.

Research methodology: This study was cross-sectional descriptive research. The representative sample included total of 30 warfarin patients who received treatment at Warfarin Clinic, Khonsawan Hospital. Data were collected by INHOMESSS home visit interview and the form for assessing knowledge about warfarin use between July and September 2023. Data were analyzed by using descriptive statistics, number, percentage, mean and standard deviation.

Research results: The representative sample had indications for warfarin use due to Atrial fibrillation (76.7 percent) and co-morbidities (73.3 percent). Furthermore, the majority were elderly (90.0 percent). Detected problems from medication included not being medicated as prescribed by the doctor (60.0 percent) and drug interactions due to eating green leafy vegetables more, including herbal women's medicines (36.7 percent). Additionally, it was found that the representative sample had no caregivers for medication (76.7 percent), resulting in taking medicine incorrectly (56.7 percent). Knowledge testing revealed the topics of symptoms of blood clots, contraindications or practices for taking warfarin and practices for buying medicine to take personally remaining in relatively small proportions (0.0 to 30.0 percent). After home visits, the score proportions of such knowledge increased on all topics (66.7 to 100.0 percent) and INR value was in the therapeutic range of 86.7 percent.

Conclusion and recommendations: Home visits have affected patients' knowledge and understanding of possibly influencing practices, resulting in INR values in the therapeutic range. Moreover, public health personnel have been aware of the problems, which will lead to the design of concrete solutions to the problems.