Patient knowledge and perceptions of atrial fibrillation and anticoagulant therapy: effects of an educational intervention programme. The West Birmingham Atrial Fibrillation Project

OBJECTIVE: Previous research has demonstrated that patients with atrial fibrillation (AF) possess very little knowledge of their disease, the consequences of AF and the benefits/risks of anti-coagulant therapy. The aim of this pilot study was to examine patient's knowledge and perceptions of AF and their anticoagulant treatment before and after a brief educational intervention. MATERIALS AND METHODS: Ninety-three patients (47 male; mean (S.D.) age 67.3 (11.6) years) completed the baseline interview to assess their knowledge and perceptions of AF. All patients were given an information booklet which explained what AF was, associated symptoms, the possible causes and consequences of AF, treatment options and their benefits/risks, what the INR is and what factors may effect it. The booklet was explained to each patient by the researcher and given to the patient to take away for reference. Thirty-three (35.5%) patients (12 men; mean (S.D.) age 68.0 (13.6) years) completed the follow-up assessment to re-assess their knowledge and perceptions of AF. RESULTS: Only 49% of patients could name their cardiac condition at baseline, although the majority were aware that AF was an arrhythmia (80% baseline vs. 91% follow-up). Only about half the patients perceived AF as a serious condition or were aware that AF predisposes to thromboembolism at baseline. Following the educational intervention there was a non-significant increase in patient knowledge of the risks associated with AF. Of those who completed both questionnaires, 52% were aware that anticoagulants prevented blood clots, which increased to 70% post-intervention. However, few patients were aware of the benefit of stroke prevention associated with anticoagulants at baseline (21%) or after the educational intervention (27%). The intervention had little effect on increasing awareness of the bleeding risks associated with anticoagulants, although three in five people appeared to appreciate these risks. However, the educational intervention significantly improved patient's knowledge of the target INR range and factors that may affect INR levels (p=0.001 and p=0.014, respectively) for those who completed both questionnaires. CONCLUSIONS: Most patients with AF possess very limited knowledge about their cardiac condition, its consequences, and how anticoagulant treatment can benefit them. This pilot study has demonstrated that a brief educational intervention with an information booklet can help to somewhat improve their knowledge about anticoagulation therapy for AF.