[Educational role of community nurse in care of patients treated with oral anticoagulation therapy].

Unlabelled: Different methods allowing for assessment of anticoagulation effects in patients receiving oral anticoagulants (OAC) are applied. Among them estimation of total time of international normalized ratio (INR) within the therapeutic range (time in therapeutic range--TTR) is used. The aim of the study was to assess the knowledge of patients about safety measures when on acenocumarol (AC) therapy as well as to measure TTR and potential impact of education provided by community nurse on TTR.

Material And Methods: The study lasted for 20 months since August 2006 till March 2008. Twenty-five patients remaining under care of a family physician were interviewed about safety rules while on treatment with AC. In May 2007 an educational intervention was provided by a trained community nurse.

Results: We have shown that older age was related to lower number of correct responses to questions (p < 0.064). Individuals with higher number of correct responses measured their INR more frequently, statistically significant difference (p < 0.045). TTR of all subjects before education was 48% and increased after education to 52%. We have shown that changes of TTR after education were related to education, age group and gender. The biggest improvement of TTR was observed among people younger than 75 years of age and those with higher education (not statistically significant differences).

Conclusions: Education has biggest effect in persons under 75 years and with higher education. Older persons and those less educated require longer education and monitoring by health care professionals to maintain INR in the therapeutic range. Patients with better knowledge about DAK--monitor INR more frequently and their anticoagulation is better controlled.