社團法人臺灣臨床藥學會

已出刊文章

【原著】新型與傳統口服抗凝血劑於心房纖維顫動病人用藥認知之差異
Differences in Medication Cognition Between Novel and Traditional Oral Anticoagulants in Patients With Atrial Fibrillation
心房纖維顫動,Warfarin,新型口服抗凝血劑,病人衛教、Atrial Fibrillation、Novel Oral Anticoagulants, Patient Education
許杏如Hsiu-Ju Hsu1,* 、陳姿君Zih-Jun Chen1 、羅惠珍Hui-Chen Lo1 、黃秋谷Chiu-Ku Huang1
1台南市立醫院(委託秀傳醫療社團法人經營)藥劑科
目的:口服抗凝血劑可顯著降低心房纖維顫動 (atrial fibrillation, AF) 病人的 中風風險,用藥選擇包括warfarin 及新型口服抗凝血劑 (novel oral anticoagulants, NOACs)。為提升AF 病人服藥順從性,對藥品療效、交互作用及出血風險有所認 知,口服抗凝血劑用藥衛教是一項重要的藥事照護。本研究評估分別接受 warfarin 與 NOACs 用藥衛教個案,衛教執行成效是否存在差異。 方法:以診斷為 AF 並曾接受 warfarin 或 NOACs 用藥衛教的病人為研究對象, 採問卷調查方式,比較其用藥認知。以4 個面向進行評估,包括「藥品治療目的認 知」、「服藥順從性」、「藥物─保健食品交互作用認知」及「藥品出血風險認知」。 結果:本研究總共收納100 位個案,NOACs 75 位,warfarin 25 位。用藥認知 評估結果,同意抗凝血劑必須長期服用,warfarin 組比率較高 (68.0 vs. 92.0%, p < 0.05),服藥順從性及交互作用的認知,2 組比較無統計學差異,對於出血風險認知之 比較,warfarin 組比率較 NOACs 高 (38.7 vs. 68.0%, p < 0.05) 。 結論:本院現行 NOACs 用藥教育,仍需加強 AF 病人對於長期用藥及出血副作 用的認知。
 
ABSTRACT 
 
Objective: Oral anticoagulants, including warfarin and novel oral anticoagulants (NOACs), can significantly reduce the risk of stroke in patients with atrial fibrillation (AF). This study evaluated the impact of educational interventions with respect to oral anticoagulants on patients with AF and compared the differences between medication cognition in patients taking warfarin and those taking NOACs. Methods: This study was conducted using questionnaire survey to compare the differences in medication cognitions between the patients with AF who had received educational interventions with respect to warfarin and NOACs. We evaluated four aspects, including cognitions of medication purposes, medication adherence, drughealth food interactions, and bleeding risks. Results: This study included 100 cases: 75 in the NOACs group and 25 in the warfarin group. Following the educational interventions for medication cognition, the number of individuals agreeing that it was important to take long-term oral anticoagulants was higher in the warfarin group than in the NOACs group (68.0 vs. 92.0%, p < 0.05). There were no statistical differences between the warfarin and NOACs groups with respect to medication adherence and cognition of drug interactions. Moreover, the number of individuals with cognition for bleeding risks was higher in the warfarin group than in the NOACs group (38.7 vs. 68.0%, p < 0.05). Conclusions: In our hospital, it is necessary to improve the present educational interventions for the cognition of the effects of long-term medication and consequent bleeding risks in patients with AF taking NOACs. 
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