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. 2019 Jun 26;55(7):313.
doi: 10.3390/medicina55070313.

Physicians' Perceptions of Their Patients' Attitude and Knowledge of Long-Term Oral Anticoagulant Therapy in Bulgaria

Nikolay Runev  1 , Tatjana Potpara  2 , Stefan Naydenov  3 , Anita Vladimirova  4 , Gergana Georgieva  5 , Emil Manov  6
Affiliations

Physicians' Perceptions of Their Patients' Attitude and Knowledge of Long-Term Oral Anticoagulant Therapy in Bulgaria

Nikolay Runev et al. Medicina (Kaunas). .

Abstract

Background and Objectives: Oral anticoagulation (OAC) is widely used in daily clinical practice worldwide for various indications. We aimed to explore the perception of Bulgarian clinicians about their patients' attitude and knowledge of long-term OAC, prescribed for atrial fibrillation (AF) and/or known deep venous thrombosis (DVT)/pulmonary embolism (PE). Materials and Methods: We performed a cross-sectional study that involved 226 specialists: 187 (82.7%) cardiologists, 23 (10.2%) neurologists, and 16 (7.1%) vascular surgeons. They filled in a questionnaire, specially designed for our study, answering various questions regarding OAC treatment in their daily clinical practice. Results: The mean prescription rate of OACs in AF patients was 80.3% and in DVT/PE-88.6%. One hundred and eighty-seven (82.7%) of the participants stated they see their patients on OAC at least once per month. According to more than one-third of the inquired clinicians, the patients did not understand well enough the provided information concerning net clinical benefit of OAC treatment. About 68% of the clinicians declared that their patients would prefer a "mutual" approach, discussing with the physician the OAC options and taking together the final decision, whereas according to 43 (19.0%), the patients preferred the physician to take a decision for them. Patients' OAC treatment had been interrupted at least once within the last year due to a physician's decision by 178 (78.8%) of the participants and the most common reason was elective surgery. The most influential factors for a patient's choice of OAC were the need of a specific diet to be kept, intake frequency, and possible adverse reactions. Conclusions: Our results suggest that a clinician's continuous medical education, shared decision-making, and appropriate local strategies for improved awareness of AF/DVT/PE patients are key factors for improvement of OAC management.

Keywords: anticoagulation; atrial; fibrillation; perception; thrombosis; venous.

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Conflict of interest statement

Nikolay Runev has received research contracts and honoraria for lectures from Boehringer Ingelheim; Tatjana Potpara declares no conflict of interest; Stefan Naydenovhas received honoraria for lectures from Boehringer Ingelheim; Emil Manov declares no conflict of interest; A.V. and Gergana Georgieva are full-time employees of Boehringer Ingelheim; Boehringer Ingelheim supported technically the conductance of the current study without financial funding; Nikolay Runev, Stefan Naydenov, Tatjana Potpara, Emil Manov, and the participants in the study received no financial support/reward for conductance of the study.

Figures

Figure 1
Figure 1
Some basic characteristics of the OAC treatment according to the patients (the information was provided by their physicians); DVT—deep venous thrombosis; PE—pulmonary embolism.
Figure 2
Figure 2
Rankings of factors of the surveyed physicians based on their responses to the question “If you had to discuss with your patients the OAC to be prescribed, which three factors they would consider the most important in your opinion?” (absolute number; relative share).
Figure 3
Figure 3
(a) Importance of five basic complications according to the physicians, when choosing an OAC. (b) Importance of five basic complications according to the patients, when choosing an OAC (the information was provided by their physicians); DVT—deep venous thrombosis; PE—pulmonary embolism.
Figure 3
Figure 3
(a) Importance of five basic complications according to the physicians, when choosing an OAC. (b) Importance of five basic complications according to the patients, when choosing an OAC (the information was provided by their physicians); DVT—deep venous thrombosis; PE—pulmonary embolism.
Figure 4
Figure 4
Sources of information from the surveyed physicians based on their responses to the question “What sources, in your opinion, do patients use to get information about the OAC they are taking?”.
See this image and copyright information in PMC

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