Study On Related Factors With Oral Warfarin Adherence Of Postoperative Patients Of Mechanical Heart Valve Replacement

BackgroundPostoperative patients of artificial mechanical valve replacement need to receive long-term oral warfarin anticoagulant treatment.But with a narrow therapeutic window of warfarin,the individual dose of patients is significantly different,which makes it difficult to achieve optimum anticoagulation.They need regularly monitoring INR to adjust the warfarin dose.Taking warfarin improperly may lead to adverse events such as bleeding and thrombus,thus,medication adherence is particularly important.At present,the studies on the related factors with medication adherence of warfarin of postoperative artificial mechanical valve replacement are rare in China.This paper aims to discuss the probable related factors that may affect medication adherence of patients,in order to provide a better medication guide for patients,reduce the incidence of adverse events,and also provide data support for clinical decision.ObjectiveTo investigate the factors affecting oral warfarin adherence in postoperative patients of mechanical valve replacement.MethodA retrospective study was performed on 108 patients undergoing mechanical valve replacement surgery at the First Affiliated Hospital of Zhengzhou University by recording outpatient’s information and telephone follow-up from September 2017 to February 2019.Record the patient’s general information(including gender,age,ethnicity,place of residence,type of valve replacement surgery,etc.),factors that may affect medication adherence(including education,monthly income,smoking,drink,family intervention),adverse events(thrombosis or embolism,bleeding),etc.The patient’s medication adherence was investigated by questionnaire and the influence of these factors on medication adherence was analyzed.ResultsA total of 108 postoperative patients with heart mechanical valve replacement were included in the study.Among them,86 patients(79.6%)had high medication adherence and 22 patients(20.4%)had low medication adherence,indicating that most patients who received warfarin anticoagulant therapy after surgery.Through the difference analysis,it was found that the patient’s gender,education level and family intervention were related to their medication compliance.Besides regression analysis showed that education level was an independent predictor of patient’s adherence.ConclusionOral warfarin adherence was better in most patients after MVHR surgery.Patient’s gender,education level,and family intervention affect the patient’s medication adherence,education level is an independent factor of patient’s medication adherence.