Adherence To Anticoagulant Therapy And Quality Of Life In Patients With Mechanical Heart-Valve Replacement

Objectives To investigate adherence to warfarin, quality of life in discharged patients after mechanical heart valve replacement, and explore the predictors of patients’ quality of life so as to make the targeted intervention strategies, improve patients’ quality of life to reduce complications and mortality, but also provide a reference basis for the application to other chronic patients’ quality of life research, and for the formulation of our management system about management..Methods Subjects were selected from a convenience sample that patients with mechanical heart valve replacement during January in2011to February in2012in an three level of first-class university affiliated hospital. The study conducted the questionnaire survey by telephone interview. From May1st,2013to December31th, investigation was implemented and Questionnaires were filled by the investigator according to answers of the subjects. The questionnaires included three parts:the general information questionnaire, the Chinese Revised8Item Morisky Medication Adherence Scale(MMAS-8), SF-36. Using SPSS17.0statistical software for data entry and analysis, including descriptive analysis,two independent samples t test, single factor variance analysis and multiple linear stepwise regression analysis.Results A total of195patients were investigated by telephone interview and183(93.85%)effective questionnaire have been got. Detailed information was as follows: l.The QOL scores was611.29±92.78for discharged patients after MHVR, a each dimension score lower than the general population;2.The MMAS-8scores was7.19±0.98,overall in the medium level,49.20%of the patients taking warfarin compliance level is high, medium and low compliance level accounted for37.70%and13.10%respectively;3. The characteristics of different population sociology and disease MHVR patients QOL score difference was statistically significant:women, illiteracy and primary school, unmarried, on-the-job, drinking, family per capita monthly income<1000yuan, with other drugs, grade Ⅲ PTPS, and cardiac function in patients with QOL score lower than male, high school and above, married, unemployed,1000-2000yuan,2000-3000yuan and>3000yuan1, merging, and two other drugs, not Ⅰ PTPS, and cardiac function and Ⅱ patients;4. QOL for multiple linear stepwise regression analysis showed that occupation, PTPS, kinds, the cardiac function (compared with cardiac Ⅱ level, cardiac function Ⅰ QOL in patients with a higher level of cardiac function grade Ⅲ QOL in patients with lower), marital status (compared with unmarried, married QOL scores high) medication adherence (compared with low compliance of patients, patients with higher QOL in higher) and kinds (compared with not taking drugs, drug varied lower QOL), occupation (science and technology, civil servants, service personnel compared with farmers, low score, unemployed score lower than farmers) postoperative hospital patients taking warfarin is MHVR adherence of prediction variables (R2=58.1%).Conclusion1. MHVR patients lower quality of life, lower than the national norm, the need to formulate corresponding measures, improve the patient’s quality of life;2. Taking MHVR patients taking warfarin sexual phenomenon is not optimistic,50.80%of patients taking warfarin adherence at lower levels, improve patients taking warfarin, it is necessary to solve the compliance for the patients with anticoagulation control and lower anticoagulation complications are particularly important;3. The patients’ QOL and the patient’s gender, marital status, occupation, alcohol consumption, cultural degree, family per capita income, merging other kinds, PTPS and was significantly associated with the current level of cardiac function, in which women, illiteracy, family per capita monthly income<above1000yuan, with three other drugs and heart function, class Ⅲ lowest quality of life of patients;4. Heart function, marital status, educational level, PTPS, occupation, merging other medication is taking warfarin in patients with low compliance predictors of heart function and clinical medical personnel should be strengthened to class Ⅲ, unmarried, illiterate, unemployed and PTPS, merge three or more other types of drugs such as high-risk patients...