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Kulthanachairojana N, Kangwanrattanakul K, Khongmee T, Pawasan N, Chityam S, Pornwattanakavee S. Health-related quality of life and willingness to pay measurement among patients on warfarin in Thailand. J Pharm Policy Pract 2023; 16:130. [PMID: 37904238 PMCID: PMC10614390 DOI: 10.1186/s40545-023-00632-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Accepted: 10/09/2023] [Indexed: 11/01/2023] Open
Abstract
BACKGROUND Complex dosage regimens and the high incidence of adverse events associated with warfarin therapy can affect the health-related quality of life (HRQoL) and willingness to pay (WTP) among patients on warfarin. No such previous study has been conducted to assess the HRQoL and WTP among Thai patients on warfarin; therefore, this study aimed to measure these parameters and identify some sociodemographic factors associated with those aspects among patients on warfarin in Thailand. METHODS This cross-sectional survey study involving 260 patients on warfarin between June 2022 and June 2023 used a quantitative method for data collection. Face-to-face interviews with well-trained interviewers were conducted and patients were required to complete the questionnaires of both World Health Organization Quality of Life-BREF (WHOQOL-BREF) and EQ-5D-5L to assess and measure their HRQoL levels. WTP was assessed using a bidding game technique. Descriptive statistics with mean and standard deviations were used to report HRQoL scores and WTP, whereas a generalized linear model was employed to identify factors associated with both HRQoL and WTP. RESULTS The mean EQ-5D index and mean EQ-VAS score were 0.89 ± 0.15 and 76.92 ± 15.95, respectively, whereas the mean WHOQOL-BREF domain scores were 59.18 ± 14.13, 68.56 ± 15.47, 59.13 ± 19.64, and 65.23 ± 14.04 for the physical, psychological, social, and environmental domains, respectively. Elderly participants (age > 60 years) and those with comorbidities had lower HRQoL scores than their counterparts. The mean WTP was 22.25 ± 32.19 USD for one patient's visit. The presence of comorbidities was the only factor significantly associated with WTP values. CONCLUSIONS Thai patients on warfarin have lower mean EQ-5D indexes and EQ-VAS scores than members of the general Thai population. Patients on warfarin with comorbidities have diminished HRQoL and WTP values. Therefore, all healthcare professionals should pay more attention to this group of patients on warfarin to achieve better outcomes.
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Affiliation(s)
- Nattanichcha Kulthanachairojana
- Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, 169 Long-Hard Bangsaen Rd., Mueang, Chonburi, 20131, Thailand
| | - Krittaphas Kangwanrattanakul
- Division of Social and Administrative Pharmacy, Faculty of Pharmaceutical Sciences, Burapha University, 169 Long-Hard Bangsaen Rd., Mueang, Chonburi, 20131, Thailand.
| | | | - Nampratai Pawasan
- Department of Pharmacy, Faculty of Medicine, Burapha University hospital, Chonburi, Thailand
| | - Sitanan Chityam
- Department of Pharmacy, Banglamung hospital, Chonburi, Thailand
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Penjore Y, Dorji T, Dorji S, Tamang ST. Profile and outcome of patients with Warfarin Toxicity admitted in a tertiary care hospital in Bhutan: a cross-sectional study investigators and institutions. BMC Res Notes 2023; 16:81. [PMID: 37202815 DOI: 10.1186/s13104-023-06359-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 05/11/2023] [Indexed: 05/20/2023] Open
Abstract
OBJECTIVE To study the profile, clinical presentation and outcome of hospital stay among patients admitted with warfarin toxicity at the Jigme Dorji Wangchuck National Referral Hospital, Bhutan. This was a cross-sectional study with a review of hospital records of patients admitted between 01 and 2018 and 30 June 2020. RESULTS There were 22 admissions due to warfarin toxicity. The mean age of patients was 55.9 (± SD 20.2) years, the median duration of warfarin therapy was 30 months (IQR 4.8, 69 months). The indications for warfarin were atrial fibrillation (9, 40.9%), mechanical heart valves (6, 27.3%), deep vein thrombosis (6, 27.3%) and pulmonary thromboembolism (1, 4.5%). The mean of dosage of warfarin was 4.3 (± 2.6) mg and the cumulative dosage in the week prior to admission was 30.9 (± 18.6) mg. The mean of INR at presentation was 7.7 (± 4.3) with the maximum noted at 20. The patients presented with gastrointestinal bleeding, muscle haematomas, epistaxis and oral cavity bleeding. There was no mortality related to warfarin toxicity. The reasons for warfarin toxicity included patient dosing error and drug interactions. Warfarin therapy requires appropriate patient education, adequate facilities for follow-up and avoidance of warfarin wherever possible in clinical settings.
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Affiliation(s)
- Yeshey Penjore
- Department of Internal Medicine, Jigme Dorji Wangchuck National Referral Hospital, Thimphu, Bhutan.
| | - Thinley Dorji
- Department of Internal Medicine, Central Regional Referral Hospital, Gelegphu, 31101, Bhutan.
| | - Sangay Dorji
- Faculty of Postgraduate Medicine, Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Saran Tenzin Tamang
- Department of Internal Medicine, Central Regional Referral Hospital, Gelegphu, 31101, Bhutan.
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Ghazy RM, Abubakar Fiidow O, Abdullah FSA, Elbarazi I, Ismail II, Alqutub ST, Bouraad E, Hammouda EA, Tahoun MM, Mehdad S, Ashmawy R, Zamzam A, Elhassan OM, Al Jahdhami QM, Bouguerra H, Kammoun Rebai W, Yasin L, Jaradat EM, Elhadi YAM, Sallam M. Quality of life among health care workers in Arab countries 2 years after COVID-19 pandemic. Front Public Health 2022; 10:917128. [PMID: 36408035 PMCID: PMC9669412 DOI: 10.3389/fpubh.2022.917128] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022] Open
Abstract
Background Assessment of the quality of life (QoL) among healthcare workers (HCWs) is vital for better healthcare and is an essential indicator for competent health service delivery. Since the coronavirus disease 2019 (COVID-19) pandemic strike, the frontline position of HCWs subjected them to tremendous mental and psychological burden with a high risk of virus acquisition. Aim This study evaluated the QoL and its influencing factors among HCWs residing in the Arab countries. Methods This was a cross-sectional study using a self-administered online questionnaire based on the World Health Organization QoL-BREF instrument with additional questions related to COVID-19. The study was conducted in three different languages (Arabic, English, and French) across 19 Arab countries between February 22 and March 24, 2022. Results A total of 3,170 HCWs were included in the survey. The majority were females (75.3%), aged 18-40 years (76.4%), urban residents (90.4%), married (54.5%), and were living in middle-income countries (72.0%). The mean scores of general health and general QoL were 3.7 ± 1.0 and 3.7 ± 0.9, respectively. Those who attained average physical, psychological, social, and environmental QoL were 40.8, 15.4, 26.2, and 22.3%, respectively. The income per capita and country income affected the mean scores of all QoL domains. Previous COVID-19 infection, having relatives who died of COVID-19, and being vaccinated against COVID-19 significantly affected the mean scores of different domains. Conclusion A large proportion of the Arab HCWs evaluated in this study had an overall poor QoL. More attention should be directed to this vulnerable group to ensure their productivity and service provision.
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Affiliation(s)
- Ramy Mohamed Ghazy
- Tropical Health Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Osman Abubakar Fiidow
- School of Public Health and Research, Somali National University, Mogadishu, Somalia
| | | | - Iffat Elbarazi
- Institute of Public Health, College of Medicine & Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates,*Correspondence: Iffat Elbarazi
| | - Ismail Ibrahim Ismail
- Department of Neurology, Ibn Sina Hospital, Sabah Medical Region, Kuwait City, Kuwait
| | - Sulafa Tarek Alqutub
- Department of Family and Community Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Etwal Bouraad
- Department of Epidemiology and Population Health Sciences, American University of Beirut, Beirut, Lebanon,School of Pharmacy, Lebanese International University, Beirut, Lebanon
| | - Esraa Abdellatif Hammouda
- Clinical Research Department, El-Raml Pediatric Hospital, Ministry of Health and Population, Alexandria, Egypt
| | - Mohamed Mostafa Tahoun
- Department of Epidemiology, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Silmane Mehdad
- Research Centre in Genomics of Human Pathologies, Faculty of Science, Mohammed V University in Rabat, Rabat, Morocco
| | - Rasha Ashmawy
- Department of Clinical Research, Maamoura Chest Hospital, MoHP, Alexandria, Egypt
| | | | | | | | | | - Wafaa Kammoun Rebai
- Laboratory of Biomedical Genomics and Oncogenetics, Institut Pasteur de Tunis, Tunis, Tunisia
| | - Lina Yasin
- Ministry of Public Health and Population, Sanaa, Yemen
| | | | - Yasir Ahmed Mohammed Elhadi
- Department of Public Health, Medical Research Office, Sudanese Medical Research Association, Khartoum, Sudan
| | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan,Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan,Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
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Dsouza JP, Chakrabarty J, Ramachandran P, Guddattu V, Nayak BS, George A. Effectiveness of a Nursing Intervention Module on Adherence, Knowledge, Quality of Life, and Complications Among Patients Receiving Anticoagulation therapy-a Randomized Controlled Trial Protocol. Patient Prefer Adherence 2022; 16:1723-1731. [PMID: 35903081 PMCID: PMC9314451 DOI: 10.2147/ppa.s365585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/27/2022] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Cardiovascular diseases are one of the major causes of mortality at the global level. They account for approximately 17.9 million deaths per year. Warfarin and acenocoumarol are the commonly used oral anticoagulants to treat and prevent thromboembolic disorders in patients with cardiovascular diseases. In India, approximately 2-2.5 million patients with rheumatic heart disease are receiving oral anticoagulation therapy. Additionally, this therapy is provided for stroke prevention in the case of atrial fibrillation and the treatment of valvular heart disease, stroke, and deep vein thrombosis. As the therapeutic range of these drugs is narrow and is affected by many factors, their use is challenging. This study aims to evaluate the effectiveness of a nursing intervention module in terms of adherence to therapy, knowledge, quality of life, and complications among patients receiving oral anticoagulation therapy. Furthermore, this study will address factors that affect adherence and the risk for bleeding by using a randomized controlled trial design. METHODS This single-blind, single-center, randomized controlled trial will focus on adherence to oral anticoagulation therapy. A total of 320 patients who are on oral anticoagulation therapy will be randomized into blocks and allocated to either the intervention or standard care group. The intervention will comprise the use of a nursing intervention module that includes a booklet, log sheet, and decision aid on oral anticoagulation therapy adherence. Outcome measures, that is, knowledge regarding oral anticoagulation therapy, adherence, complications, and quality of life, will be assessed at the baseline and during follow-ups. DISCUSSION Patient safety can be best achieved through patients' adherence to medication dose and monitoring of blood test values. Thromboembolic and bleeding complications are likely to occur when either the patient does not adhere to the treatment or the therapeutic range of the international normalized ratio is not maintained. This study will assess the nonadherence behavior and the effectiveness of a nursing intervention module toward adherence behavior. TRIAL REGISTRATION This research project is registered under the Clinical Trial Registry of India (CTRI/2019/06/019610).
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Affiliation(s)
- Janet Prameela Dsouza
- Department of Medical-Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Jyothi Chakrabarty
- Department of Medical-Surgical Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Correspondence: Jyothi Chakrabarty, Professor and Head, Department of Medical-Surgical Nursing, Manipal College of Nursing Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India, Tel +91 9880078542, Email
| | - Padmakumar Ramachandran
- Department of Cardiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
- Padmakumar Ramachandran, Professor and Unit Head, Department of Cardiology, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, 576104, India, Tel +91 9900921428, Email
| | - Vasudeva Guddattu
- Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Baby S Nayak
- Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Anice George
- Department of Child Health Nursing, Manipal College of Nursing, Manipal Academy of Higher Education, Manipal, Karnataka, India
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