PB0497 - Educational intervention effectiveness evaluated with time in therapeutic range in patients with atrial fibrillation and low educational level and social vulnerability in Corrientes Argentina

Monday, July 11, 2022

6:30 PM – 7:30 PM

Location: Exhibition

Presentation Format: In-Person

Presenting Author(s)

Carla P. Giumelli, MD

Chief
Instituto de Cardiología de Corrientes
corrientes, Corrientes, Argentina

Co-Author(s)

FF

Farias Eduardo Francisco
JP

Jorge Isaac Parras
MM

María Fernanda Medina

Background: Atrial fibrillation (AF) is the most prevalent arrhythmia in adults and is related with an increased risk of stroke. Oral anticoagulation treatment, with vitamin k antagonists (VKA) significantly reduced the risk of stroke, but require adequate percentage of time in therapeutic range (TTR), greater than 65%. Limited knowledge of their condition and therapy may contribute to not reach this objective. Social and educational vulnerability defined as illiterated or less than 7 years school education and/or very low incomes (USD 250) are predictors for low TTR.

Aims: Evaluate the impact of educative videos to improve the TTR in patients with social and educational vulnerabilities

Methods: We compared the effect of an educational intervention with usual care in patients with nonvalvular atrial fibrillation (NVAF) treated with VKA.
Prospective pre-post study, comparing ”usual care management” care versus ”patient education”, using 4 educational videos containing information on the AF, symptoms, treatment, importance of adhering to recommendations and therapy followed by interviews with a doctor emphasizing the contents. They were carried out individually, and on two occasions the accompaniment of a cohabitant was requested. The primary endpoint was TTR and the secondary endpoint included knowledge.

Results: From 131 patients,110 were analysed. (see flowchart). The mean age was 71.3 ± 9.5 years, 56.5% male, the average CHA2DS2-VASc 3.7 and 48.7% only had complete primary education with 10.4% illiterate. Characteristics TABLE 1.
The mean pre-intervention TTR was 61% and the post-intervention was 77% (I95% CI 3-28%) with P = 0.0053 that was maintained for a mean time of 300 days.
The Hendriks questionnaire was carried out to evaluate knowledge that showed good performance in questions related to anticoagulant therapy and limiting questions related to symptoms and therapy directed to arrhythmia.

Conclusion(s): The use of videos as an educational intervention was effective in improving the TTR iin a population with socio-educational vulnerability.