Bryan Wacker, DO
Resident Physician - PGY-3
University of Missouri - Physical Medicine and Rehabilitation
Columbia, Missouri, United States
Claire Finkel, MD
Program Director
University of Missouri Dept. of Physical Medicine and Rehabilitation
Columbia, Missouri, United States
Connor Swartz, DO, DO
Resident Physician
University of Missouri Dept. of Physical Medicine and Rehabilitation
Columbia, Missouri, United States
Many patients suffering from strokes, heart disease, thromboembolism, and vascular disease have anticoagulants initiated in the acute care setting and continued on discharge to inpatient rehabilitation (IPR). The purpose of this project was to measure the knowledge IPR patients have of anticoagulants prescribed at the acute care hospital. The project also sets the stage to implement education during their stay to prevent future adverse events from misuse.
Design:
Study Population: Discharged acute care hospital patients that were initiated on anti-platelet or anti-coagulation therapy prior to IPR. Patients required to be alert and oriented with no prior history of cognitive disease.
Initial interview and scoring of patient by physician upon IPR admission with the following questions asked:
Were you prescribed a blood thinner prior to discharge?
What is the blood thinner you were prescribed called?
Why were you prescribed this blood thinner?
How long do you need to be on this blood thinner?
What medications should you avoid while on this medication?
A correct answer to each question yielded 1 point for a max potential total of 5
Results:
The average age of the enrolled patients was 69 years with the most common anticoagulant prescribed being Eliquis. The most common diagnosis for anticoagulation start among patients was stroke (33.3%) followed by atrial fibrillation (18.5%). The average survey score was 1.41/5. The questions most frequently missed were duration of therapy (85% answering incorrectly) and medication name (81.5% answering incorrectly). The question most frequently answered correctly was if they were sent over on a blood thinner (55.6% answering correctly).
Conclusions: Oral anticoagulants are not benign medications. It is clear patients have poor knowledge of these medications which is likely contributing to adverse events after discharge home. Continued education is vital to help patients understand the risks of these medications and prevent future hospitalizations
