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Necessary Patient/family Education Regarding Anticoagulant Therapy Includes the Following

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Best strategies for patient education about anticoagulation with warfarin: a systematic review

BMC Health Services Research volume 8, Article number:40 (2008) Cite this article

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Abstract

Background

Patient didactics is an essential component in quality management of the anticoagulated patient. Because it is fourth dimension consuming for clinicians and overwhelming for patients, pedagogy of the anticoagulated patient is ofttimes neglected. Nosotros surveyed the medical literature in guild to identify the best patient education strategies.

Methods

Study Option: Two reviewers independently searched the MEDLINE and Google Scholar databases (terminal search March 2007) using the terms "warfarin" or "anticoagulation", and "patient education". The initial search identified 206 citations, A full of 166 citations were excluded considering patients were of pediatric age (4), the article was not related to patient pedagogy (48), did not contain original information or inadequate program description (141), was focused solely on patient self-testing (one), was a duplicate citation (iii), the commodity was judged otherwise irrelevant (44), or no abstract was available (25).

Data Extraction: Clinical setting, study blueprint, group size, content source, fourth dimension and personnel involved, educational strategy and domains, measures of knowledge retention.

Results

Data Synthesis: A total of 32 manufactures were ultimately used for information extraction. Thirteen manufactures fairly described features of the educational strategy. 5 programs used a nurse or pharmacist, 4 used a doc, and 2 studies used other personnel/vehicles (lay educators (i), videotapes (i)). The duration of the educational intervention ranged from 1 to 10 sessions. Patient grouping size most often averaged 3 to 5 patients but ranged from every bit low as i patient to as much as 11 patients. Although 12 articles offered information nearly teaching content, the wording and lack of particular in the description made information technology also difficult to accurately assign categories of didactics topics and to compare articles with one another. For the 17 articles that reported measures of patient knowledge, v of the 17 sites where the surveys were administered were located in anticoagulation clinics/centers. The number of questions ranged from as few as four to equally many as 28, and questions were most often of multiple choice format. Iii were cocky-administered, and 2 were completed over the telephone. Two reports described instruments along with formal testing of the validity and reliability of the instrument.

Conclusion

Published reports of patient didactics related to warfarin anticoagulation vary profoundly in strategy, content, and patient testing. Prioritizing the educational domains, standardizing the educational content, and delivering the content more than efficiently will exist necessary to amend the quality of anticoagulation with warfarin.

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Background

Warfarin is a dangerous outpatient medication, by anyone's estimation. Information technology is the second nearly mutual cause of agin drug events in emergency rooms, and the overall risk of major haemorrhage averages vii–viii% per year [1, 2]. Despite the take a chance, well-established indications for warfarin are increasing in prevalence with aging of the population [3, 4], and new indications for warfarin are regularly recommended [5, 6]. As a upshot, the proportion of elderly persons taking warfarin has risen to as high equally 7% [vii].

Increasing a patient's understanding virtually warfarin is a logical goal. Prior knowledge about warfarin has been associated with a decreased risk of bleeding [8]. Written and exact information has been shown to improve command of the level of anticoagulation [9]. While past studies advise that patient education may be associated with improve clinical outcomes, doubts remain most the effectiveness of patient education strategies [x–12]. As a result, systematic patient didactics regarding long-term warfarin is non universally implemented.

Our objectives were to (one) place the published strategies (duration, timing, personnel requirements, content domains) for patient education regarding warfarin anticoagulation and (2) place published instruments for measuring patient cognition.

Methods

In March 2007, we searched MEDLINE using the MESH terms ("warfarin" or "anticoagulation") AND "patient education". We limited our search to manufactures published in the English language language. We used the related articles link in PubMed and searched the references of identified citations for additional original articles. Similar search terms were used to search Google Scholar. As warfarin is past far the about ordinarily used oral anticoagulant, we did not seek manufactures related to other oral anticoagulants.

We sought articles that (a) were original research studies or descriptions of patient educational activity programs that included information on the educational content and strategy related to anticoagulation with warfarin, or (b) contained instruments that measured patient knowledge. Exclusion criteria included studies conducted in pediatric populations, unrelated to patient didactics, defective original data or an adequate programme description, and those in which the educational try was focused solely on patient self-testing. Because citations might be excluded for multiple reasons, we used this higher up mentioned sequence for excluding citations.

An initial search identified 206 citations. Ii reviewers (JLW, MDW) reviewed titles and available abstracts to determine relevance to the stated objectives of identifying (1) the optimal educational content and delivery (duration, timing, personnel requirements), and (two) the optimal strategies for measuring patient cognition. Full text articles were retrieved for citations that met our inclusion criteria and for those where inclusion/exclusion criteria were not determinable by the title and abstract. 2 other citations were encountered during the procedure of reviewing articles that were deemed eligible, raising the number of eligible manufactures to 208.

A total of 154 citations were initially excluded because patients were of pediatric age (ane.9%, four), the article was not related to patient education (23.1%, 48), did not incorporate original data or inadequate plan clarification (18.8%, 39), was focused solely on patient cocky-testing (i), was a duplicate citation (1.iv%, 3), or the article was judged otherwise irrelevant (xvi.viii%, 35), or no abstract was bachelor (11.v%, 24) (Figure 1).

Figure one
figure 1

Search strategy for studies and programs related to patient educational activity nigh warfarin anticoagulation.

Full size image

After exclusions, a total of 44 articles qualified for further review. Upon further review, an additional 12 manufactures were excluded considering of inadequate program clarification, ultimately leaving a full of 32 manufactures for data extraction (Figure 1). Nosotros extracted information on clinical setting, study pattern, grouping size, content source, time and personnel involved; and created summary tables. Ii reviewers (MDW, JLW) identified the educational topics covered in these reports. Amongst studies that tested patient cognition, we extracted data on setting and report population, number and type of questions, and method of administration.

Results

Thirteen articles had a description of the inquiry methods or program that was adequate and consistent with our objectives of identifying the duration, timing and setting, and personnel requirements of the educational programme (Table 1) [13–25]. Five programs used a nurse or pharmacist (45%), four used a physician, and 2 studies used other personnel/vehicles (lay educators (1), videotapes (1)). The duration of the educational intervention ranged from one to ten sessions. Patient group size nearly oftentimes averaged 3 to v patients but ranged from as depression as one patient to as much every bit eleven patients. While the majority of the educational efforts occurred in inpatient settings, most seemed relevant to contemporary outpatient settings.

Table 1 Patient Education Strategies Related to Warfarin and Anticoagulation

Full size table

Although twelve articles offered information nearly educational activity content, the wording and lack of detail in the description fabricated information technology too hard to accurately assign categories of teaching topics and to compare manufactures with i another [2, 11, 12, 15, 19, 22–24, 26–29]. Nevertheless, we summarized the categories suggested by these studies and listed the potential topics for each category (Table two).

Table ii Topics for Instruction of the Anticoagulated Patient

Full size table

Relevant to our objective of identifying measures of patient noesis, Table three shows the seventeen relevant citations [9, eleven, 12, 15, 18, 24, 30–40]. V of the seventeen sites where the surveys were administered were located in anticoagulation clinics/centers. The number of patients included in these studies ranged from as depression every bit 22 to as high as 530. The number of questions ranged from every bit few equally 4 to as many every bit 28 questions, and were most often of multiple selection format. Three were cocky-administered, and ii were completed over the telephone. Two citations [12, 32] described testing instruments along with formal testing of the validity and reliability of the instrument.

Table 3 Studies Testing Patient Knowledge Regarding Anticoagulation

Full size table

Discussion

Patient education has long been thought to be useful for patients receiving long-term anticoagulation. Proposals have been periodically issued suggesting the content of the educational task [ii, 23, 41]. However, inadequate attention to health pedagogy principles and educational plan pattern have more than often been the problem than have issues of content [29, 42]. Despite the practical value of making the patient equally knowledgeable every bit possible, the best strategy for educating patients virtually anticoagulation is however to be adamant [10].

The multifariousness of strategies shown in Table 1 likely reverberate a varying amount of support and resource devoted to this patient pedagogy goal. Delegating these educational activities to midlevel practitioners, pharmacists, or designated nurses are strategies well supported past the our literature review. However, in any given clinical setting, local factors such reimbursement and available manpower may make up one's mind which health professional(south) is best responsible for managing a population of anticoagulated patients. The advent of warfarin self-monitoring with abode coagulometers has sparked renewed interest in improving patient education related to anticoagulation [ii, 13]. Authorities-supported efforts in Germany and Netherlands now devote a significant level of time and manpower to this educational task [21, 43]. However, nigh clinical settings in the U.S. and elsewhere, may non be able to lucifer that level of back up [15]. Because most anticoagulation direction still takes place in the offices of clinicians [44, 45], strategies to provide education should exist relevant to all clinical settings.

We also constitute much variability in the content areas reported by educational programs, to the degree that nosotros could non accurately categorize educational domains, let solitary make fair comparisons among programs. Some issues (manifestations of bleeding, INR monitoring, etc) were a component of most educational programs, while other issues (Vitamin K, pill colour) were present only in a few. Our disability to summarize published efforts likely reflects an underreporting of details rather than extreme variability amid programs. However, our table of potential educational topics (Table two) reflects a daunting agenda.

The testing of patient noesis regarding warfarin and anticoagulation used a variety of instruments. Simply two of the sixteen instruments – the Oral Anticoagulation Cognition (OAK) instrument and the Anticoagulation Knowledge Assessment (AKA) – have been subject to whatsoever formal evaluation. The Oral Anticoagulation Knowledge (OAK) investigators evaluated construct and content validity, test-retest reliability, and internal consistency reliability [12]. The Anticoagulation Cognition Assessment (AKA) investigators used the Rasch model in social club to examine validity, and item and person reliability [32]. Both the OAK and AKA are reported to be written at the seventh grade reading level, only neither instrument has been validated in other clinical settings. The all-time strategy for measuring patient knowledge would depend, in part, on the content of the educational program, merely standardization of the testing endeavour should be a realistic goal.

The limitations of our study deserve acknowledgement. While our study reflected a variety of dissimilar strategies for all aspects of the educational procedure, it is probable that noteworthy and innovative patient education efforts may not be reflected in the medical literature. Second, in reviewing these reports, information technology is often hard to separate the management strategy from the educational strategy.

Despite the variability in the content and strategies of educational programs, several of import issues should drive future efforts at patient education, in our opinion. Educational programs should focus on topics essential for patient safety, such as what to do when INR is high, rather than the minute details of anticoagulation that overburden the patient. 2nd, these programs would all-time be implemented with measures of effectiveness and improvement in patient knowledge, adherence and outcomes using validated instruments. Lastly, educational programs should attempt to maximize office efficiency by delegating this chore to doc extenders, nurses, pharmacists, or mayhap an office-based computer.

Determination

Patient education is inbound a new era where accountability in educational outcomes, interest in literacy/language barriers, and the importance of toll-effectiveness will influence the process of patient education. Prioritizing the educational content and using validated instruments for measuring the outcomes of patient education will be a necessary first step in improving anticoagulation outcomes. This systematic review should guide future efforts.

References

  1. Wysowski DK, Nourjah P, Swartz L: Bleeding complications with warfarin utilise: a prevalent adverse effect resulting in regulatory action. Curvation Intern Med. 2007, 167: 1414-1419. 10.1001/archinte.167.xiii.1414.

    Article  PubMed  Google Scholar

  2. Ansell J, Jacobson A, Levy J, Voller H, Hasenkam JM, International Self-Monitoring Clan for Oral Anticoagulation: Guidelines for implementation of patient self-testing and patient self-management of oral anticoagulation. International consensus guidelines prepared by International Self-Monitoring Association for Oral Anticoagulation. Int J Cardiol. 2005, 99: 37-45. 10.1016/j.ijcard.2003.11.008.

    Article  PubMed  Google Scholar

  3. Segal JB, Streiff MB, Hofmann LV, Thornton K, Bass EB: Management of venous thromboembolism: A systematic review for a exercise guideline. Ann Intern Med. 2007, 146: 211-222.

    Article  PubMed  Google Scholar

  4. Baglin TP, Keeling DM, Watson HG, British Committee for Standards in Haematology: Guidelines on oral anticoagulation (warfarin): third edition – 2005 update. Br J Haematol. 2006, 132: 277-285. ten.1111/j.1365-2141.2005.05856.10.

    CAS  Article  PubMed  Google Scholar

  5. Goldhaber SZ: Low intensity warfarin anticoagulation is safety and effective every bit a long-term venous thromboembolism prevention strategy. J Thromb Thrombolysis. 2006, 21: 51-52. 10.1007/s11239-006-5576-7.

    CAS  Article  PubMed  Google Scholar

  6. Skedgel C, Goeree R, Pleasance S, Thompson 1000, O'Brien B, Anderson D: The toll-effectiveness of extended-elapsing antithrombotic prophylaxis after total hip arthroplasty. J Bone Joint Surg Am. 2007, 89: 819-828. ten.2106/JBJS.F.00092.

    Article  PubMed  Google Scholar

  7. Cuff BF, Boechler Thousand, Doggette AL, Fortune G, Flaker GC, Rich MW, Radford MJ: Agin outcomes and predictors of underuse of antithrombotic therapy in Medicare beneficiaries with chronic atrial fibrillation. Stroke. 2000, 31: 822-827.

    CAS  Article  PubMed  Google Scholar

  8. Kagansky N, Knobler H, Rimon Eastward, Ozer Z, Levy S: Safety of anticoagulation therapy in well-informed older patients. Arch Intern Med. 2004, 164: 2044-2050. 10.1001/archinte.164.18.2044.

    Article  PubMed  Google Scholar

  9. Tang EO, Lai CS, Lee KK, Wong RS, Cheng G, Chan TY: Relationship betwixt patients' warfarin knowledge and anticoagulation control. Ann Pharmacother. 2003, 37: 34-39. 10.1345/aph.1A198.

    Article  PubMed  Google Scholar

  10. Newall F, Monagle P, Johnston L: Patient understanding of warfarin therapy: a review of education strategies. Hematology. 2005, ten: 437-442. 10.1080/10245330500276451.

    Article  PubMed  Google Scholar

  11. Davis NJ, Billett HH, Cohen HW, Arnsten JH: Affect of adherence, knowledge, and quality of life on anticoagulation control. Ann Pharmacother. 2005, 39: 632-636. 10.1345/aph.1E464.

    Article  PubMed  Google Scholar

  12. Zeolla MM, Brodeur MR, Dominelli A, Haines ST, Allie ND: Evolution and validation of an musical instrument to determine patient knowledge: the oral anticoagulation cognition test. Ann Pharmacother. 2006, 40: 633-638. 10.1345/aph.1G562.

    Commodity  PubMed  Google Scholar

  13. Menéndez-Jándula B, Souto JC, Oliver A, Montserrat I, Quintana K, Gich I, Bonfill X, Fontcuberta J: Comparison self-direction of oral anticoagulant therapy with clinic direction: a randomized trial. Ann Intern Med. 2005, 142: 1-10.

    Article  PubMed  Google Scholar

  14. Koertke H, Zittermann A, Mommertz S, El-Arousy G, Litmathe J, Koerfer R: The Bad Oeynhausen concept of INR self-management. J Thromb Thrombolysis. 2005, 19: 25-31. ten.1007/s11239-005-0937-1.

    Commodity  PubMed  Google Scholar

  15. Voller H, Dovifat C, Glatz J, Kortke H, Taborski U, Wegscheider K: Self management of oral anticoagulation with the IN Ratio organisation: impact of a structured didactics program on patient's cognition of medical background and procedures. Eur J Cardiovasc Prev Rehabil. 2004, 11: 442-447. 10.1097/00149831-200410000-00014.

    Article  PubMed  Google Scholar

  16. Khan TI, Kamali F, Kesteven P, Avery P, Wynnes H: The value of education and self-monitoring in the direction of warfarin therapy in older patients with unstable control of anticoagulation. Br J Haematol. 2004, 126: 557-564. 10.1111/j.1365-2141.2004.05074.x.

    Article  PubMed  Google Scholar

  17. Gadisseur AP, Breukink-Engbers WG, van der Meer FJ, van den Besselaar AM, Sturk A, Rosendaal FR: Comparison of the quality of oral anticoagulant therapy through patient self-management and direction by specialized anticoagulation clinics in holland: a randomized clinical trial. Arch Intern Med. 2003, 163: 2639-2646. 10.1001/archinte.163.21.2639.

    CAS  Article  PubMed  Google Scholar

  18. Singla DL, Jasser Thou, Wilson R: Furnishings of group education on patient satisfaction, knowledge gained, and cost-efficiency in an anticoagulation eye. J Am Pharm Assoc (Wash). 2003, 43: 264-266. 10.1331/108658003321480786.

    Commodity  Google Scholar

  19. Amruso NA: Ability of clinical pharmacists in a community pharmacy setting to manage anticoagulation therapy. J Am Pharm Assoc. 2004, 44: 467-471. 10.1331/1544345041475751.

    Commodity  Google Scholar

  20. Beyth RJ, Quinn L, Landefeld CS: A multicomponent intervention to prevent major bleeding complications in older patients receiving warfarin. A randomized, controlled trial. Ann Intern Med. 2000, 133: 687-695.

    CAS  Commodity  PubMed  Google Scholar

  21. Mörsdorf South, Erdlenbruch W, Taborski U, Schenk JF, Erdlenbruch K, Novotny-Reichert G, Krischek B, Wenzel East: Training of patients for self-management of oral anticoagulant therapy: standards, patient suitability, and clinical aspects. Semin Thromb Hemost. 1999, 25: 109-115.

    Article  PubMed  Google Scholar

  22. Foss MT, Schoch PH, Sintek CD: Efficient functioning of a loftier-volume anticoagulation clinic. Am J Health Syst Pharm. 1999, 56: 443-449.

    CAS  PubMed  Google Scholar

  23. Sawicki PT: A structured education and cocky-management programme for patients receiving oral anticoagulation: a randomized controlled trial. Working Group for the Study of Patient Self-Management of Oral Anticoagulation. JAMA. 1999, 281: 145-150. 10.1001/jama.281.2.145.

    CAS  Article  PubMed  Google Scholar

  24. Rock S, Holden A, Knapic N, Ansell J: Comparison between videotape and personalized patient teaching for anticoagulant therapy. J Fam Pract. 1989, 29: 55-57.

    CAS  PubMed  Google Scholar

  25. Scalley RD, Kearney E, Jakobs Due east: Interdisciplinary inpatient warfarin education plan. Am J Hosp Pharm. 1979, 36: 219-220.

    CAS  PubMed  Google Scholar

  26. Fitzmaurice DA, Gardiner C, Kitchen Due south, Mackie I, Murray ET, Machin SJ, British Lodge of Haematology Taskforce for Haemostasis and Thrombosis: An evidence-based review and guidelines for patient self-testing and management of oral anticoagulation. Br J Haematol. 2005, 131: 156-165. ten.1111/j.1365-2141.2005.05739.x.

    CAS  Article  PubMed  Google Scholar

  27. Sheehan O, Stinson JC, Feely J: Establishing a principal care based anticoagulation clinic. Ir Med J. 2003, 93: 45-48.

    Google Scholar

  28. Erban Due south: Initiation of warfarin therapy: recommendations and clinical pearls. J Thromb Thrombolysis. 1999, 7: 145-148. 10.1023/A:1008833520158.

    CAS  Article  PubMed  Google Scholar

  29. Haines ST: Patient instruction: A tool in the outpatient management of deep venous thrombosis. Pharmacother. 1998, xviii (Pt 3): 158S-64S.

    CAS  Google Scholar

  30. Hu A, Grub CM, Dao D, Errett 50, Keith M: Factors influencing patient noesis of warfarin therapy after mechanical heart valve replacement. J Cardiovasc Nurs. 2006, 21: 169-175.

    Article  PubMed  Google Scholar

  31. Roche-Nagle G, Chambers F, Nanra J, Bouchier-Hayes D, Young S: Evaluation of patient cognition regarding oral anticoagulants. Ir Med J. 2003, 96: 211-213.

    CAS  PubMed  Google Scholar

  32. Briggs AL, Jackson TR, Bruce S, Shapiro NL: The development and operation validation of a tool to assess patient anticoagulation cognition. Res Social Adm Pharm. 2005, 1: xl-59.

    Article  PubMed  Google Scholar

  33. Nadar S, Begum Due north, Kaur B, Sandhu S, Lip GY: Patients' understanding of anticoagulant therapy in a multiethnic population. J R Soc Med. 2003, 96: 175-179. 10.1258/jrsm.96.4.175.

    Article  PubMed  PubMed Central  Google Scholar

  34. Cheah GM, Martens KH: Coumadin cognition deficits: exercise recently hospitalized patients know how to safely manage the medication?. Domicile Healthc Nurse. 2003, 21: 94-100. x.1097/00004045-200302000-00006.

    Article  PubMed  Google Scholar

  35. Wilson FL, Racine E, Tekieli V, Williams B: Literacy, readability and cultural barriers: disquisitional factors to consider when educating older African Americans about anticoagulation therapy. J Clin Nurs. 2003, 12: 275-282. 10.1046/j.1365-2702.2003.00711.x.

    Article  PubMed  Google Scholar

  36. Barcellona D, Contu P, Marongiu F: Patient educational activity and oral anticoagulant therapy. Haematologica. 2002, 87: 1081-1086.

    PubMed  Google Scholar

  37. Waterman AD, Milligan PE, Banet GA, Gatchel SK, Gage BF: Establishing and running an effective phone-based anticoagulation service. J Vasc Nurs. 2001, 19: 126-132. 10.1067/mvn.2001.119940.

    CAS  Article  PubMed  Google Scholar

  38. Wyness MA: Evaluation of an educational programme for patients taking warfarin. J Adv Nurs. 1990, 15: 1052-1063. 10.1111/j.1365-2648.1990.tb01986.x.

    CAS  Article  PubMed  Google Scholar

  39. Rankin MA: Programmed instruction as a patient teaching tool: a study of myocardial infarction patients receiving warfarin. Eye Lung. 1979, 8: 511-516.

    CAS  PubMed  Google Scholar

  40. Clark CM, Bayley EW: Evaluation of the use of programmed educational activity for patients maintained on warfarin therapy. Am J Public Health. 1972, 62: 1135-1139.

    CAS  Article  PubMed  PubMed Central  Google Scholar

  41. Ansell JE, Buttaro ML, Thomas OV, Knowlton CH: Consensus guidelines for coordinated outpatient oral anticoagulation therapy management. Anticoagulation Guidelines Chore Force. Ann Pharmacother. 1997, 31: 604-615.

    CAS  PubMed  Google Scholar

  42. Wyness MA: Warfarin patient pedagogy: are we neglecting the program design procedure?. Patient Educ Couns. 1989, 14: 159-169. 10.1016/0738-3991(89)90051-vii.

    CAS  Article  PubMed  Google Scholar

  43. Gadisseur AP, Kaptein AA, Breukink-Engbers WG, van der Meer FJ, Rosendaal FR: Patient cocky-management of oral anticoagulant care vs. management by specialized anticoagulation clinics: positive effects on quality of life. J Thromb Haemost. 2004, two: 584-591. 10.1111/j.1538-7836.2004.00659.10.

    CAS  Article  PubMed  Google Scholar

  44. Claes N, Buntinx F, Vijgen J, Arnout J, Vermylen J, Fieuws Due south, Van Loon H: The Belgian Improvement Study on Oral Anticoagulation Therapy: a randomized clinical trial. Eur Heart J. 2005, 26: 2159-2165. 10.1093/eurheartj/ehi327.

    CAS  Article  PubMed  Google Scholar

  45. Ansell J, Hirsh J, Poller L, Bussey H, Jacobson A, Hylek E: The pharmacology and management of the vitamin K antagonists: the Seventh ACCP Briefing on Antithrombotic and Thrombolytic Therapy. Chest. 2004, 126 (3 Suppl): 204S-233S. 10.1378/chest.126.3_suppl.204S.

    CAS  Article  PubMed  Google Scholar

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  1. Department of Internal Medicine, Wake Wood University School of Medicine, Winston-Salem, North Carolina, U.s.

    James Fifty Wofford, Megan D Wells & Sonal Singh

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Correspondence to James Fifty Wofford.

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Wofford, J.L., Wells, Yard.D. & Singh, S. Best strategies for patient teaching about anticoagulation with warfarin: a systematic review. BMC Health Serv Res 8, 40 (2008). https://doi.org/10.1186/1472-6963-8-40

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Keywords

  • Warfarin
  • Educational Program
  • Patient Education
  • Educational Content
  • Patient Knowledge

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