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Educating Patients About Atrial Fibrillation Tonya Anderson, BSN, RN, Graduate Student, PCNP Bonnie Sanderson, PhD, RN, Faculty Advisor. PURPOSE. POPULATION SAMPLE. BACKGROUND.
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Educating Patients About Atrial Fibrillation Tonya Anderson, BSN, RN, Graduate Student, PCNP Bonnie Sanderson, PhD, RN, Faculty Advisor PURPOSE POPULATION SAMPLE BACKGROUND The purpose of this project is to evaluate medication adherence and follow-up after educating patients about atrial fibrillation. Medication adherence is important in atrial fibrillation to minimize the risk of stroke and congestive heart failure. • Atrial fibrillation is the most common cardiac arrhythmia in the United States. The arrhythmia affects more than two million patients and more than 150,000 new cases are discovered each year. Atrial fibrillation has not been perceived in the past by physicians and other health care providers as a difficult cardiac condition that will affect a patient’s quality of life. Health care providers tend to fail to provide the proper patient support and education the patient needs to ensure that he/she understands the importance of following treatment. METHOD Target population: Patients with the diagnosis of atrial fibrillation who take Coumadin and a rate control medication. Outcome: Medication Adherence Measures: Morisky Medication Adherence Scale Questionnaire Small Test of Change Intervention: Education related to atrial fibrillation, Coumadin, and importance of taking medications according to the doctor’s recommendations. Follow-up: Follow-up questionnaire via phone call in 2-3 weeks after educational session. Data Analyses: Descriptive statistics and pre/post comparison of total Morisky Score. SMALL TEST OF CHANGE RESULTS PICO Morisky Scale • The results for each pre and post questionnaire ranges from 0-11 to determine medication compliance. • High compliance ranges 0-3. • Moderate compliance ranges from 4-8. • Low compliance ranges from 9-11. In patients with atrial fibrillation, how does individualized education rather than generalized education affect the patient’s ability to adhere to medication and follow-up treatment? SEARCH STRATEGY KEY REFERENCES Databases searched included CINHAL, ERIC, HealthSource, Medline, PsycInfo, and PsycArticles. Six studies were found including one Cohort study, two true experimental, one qualitative descriptive, one observation/descriptive, and one Quasi experimental. A systematic review supports the lack of knowledge in patients about atrial fibrillation, medications, and treatment. Research suggests that improved outcomes are guided by education and involvement in care. CONCLUSIONS Findings suggest: -Although the participants reported high medication compliance at baseline, improvement was noted. -The improvement in medication adherence for this small test of change 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. 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 A special thanks to Dr. TB Darji and the staff at Thomasville Internal Medicine for the support of this project, Auburn School of Nursing, and Bonnie Sanderson, PhD, RN.