Educating Patients about Atrial Fibrillation

EBP Research ProjectAuburn University/Auburn Montgomery

Location: Thomasville Internal Medicine

Tonya Anderson, BSN, RN, Graduate Student, PCNP

Outline

•PICO Question•Purpose•Significance•Summary of Evidence•Method•Sample•Findings•Summary

PICO Question

In patients with atrial fibrillation, how does

individualized education rather than generalized

education affect the patient ability to adhere to

medication?

Purpose

•Evaluate and increase medication adherence•Educate•Increase follow-up• Increase the self-management of AF• Decrease hospital stays

Significance

• Atrial Fibrillation(AF) is the most common cardiac arrhythmia in the United States (Shea and Sears, 2011)

• AF has significant complications if not managed • Stroke• Dementia• Heart Failure• Death

• Anticoagulant has serious complications if not properly regulated.

• Patient knowledge and participation in AF management leads to fewer hospital stays and decrease healthcare costs.

Summary of Evidence

• Databases: CINHAL, ERIC, HeathSource, Medline, PsycInfo, and PsycArticles.

• Six studies found• Review of research shows a lack of knowledge

in patients with Atrial Fibrillation, medication, and treatment.

• Research suggests that improved outcomes are guided by education and involvement in care.

Method

• Thomasville Internal Medicine.• Consents for eight patients.• Morisky Medication Adherence Scale given prior

to education and by follow-up phone call.• Data collected- Age, gender, and race.• Education received: Atrial Fibrillation, risks of

uncontrolled HR, Coumadin, and rate control medications.

• All data was compiled and analyzed.

Sample

• Eight participants• Diagnosis of atrial fibrillation• Take Coumadin and a rate control medication

Findings: Questionnaire

-- The lower the number, the higher the compliance.-- Results may range from 0 to 11.

Findings

• The Morisky Medication Adherence Scale (Morisky, Krousel-Wood, & Ward, 2008)

Summary

• Findings suggest: • -Although the participants reported high medication

compliance at baseline, improvement was noted.• -The improvement was not statistically significant.• - A larger sample size is warranted with a longer

evaluation period is needed to evaluate the significance of education in atrial fibrillation patients.

References

Kring, D.L. (2008). Clinical nurse specialist practice domains and evidence-based practice competencies. Clinical Nurse Specialist, 22(4), 179-183.

Morsiky, A., Krousel-Wood, M. Ward, H. (2008). Predictive validity of a medication adherence measure for hypertension control. Journal of Clinical Hypertension 10(5), 348-354.

Shea, J., & Sears, S. (2008). A patient’s guide to living with atrial fibrillation. Circulation 11, e340-e343. doi: 10.1161/CIRCULATIONAHA.108.780577

Questions???