Factors Affecting INR Level Control and Efficacy of Pill Boxes on Medication Adherence and INR Level Control in Warfarin Receiving Patients
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Abstract
Objective: To investigate factors affecting the control of International Normalized Ratio (INR) in patients receiving warfarin and to study effects of pill box on medication adherence and INR control. Method: The study was divided into two phases. Phase 1 was a cross-sectional study collecting the data to investigate factors affecting INR control. Phase 2 was a quasi-experimental study that assigned the participants into 2 groups. Experimental group received pharmaceutical care and a pill box for increasing adherence, while the control group received usual pharmaceutical care. Medication adherence was measured by pill count. Outpatients receiving warfarin at Sawangdandin Crown prince Hospital between December 1, 2016 and March 31, 2017 were recruited to the study. Results: Logistic regression analysis of 159 participants found significant factors associated with a better INR control were being married (OR=5.33; P=0.023), having education at high school or lower (OR=0.23; P=0.041) and being old cases of patients (OR=5.31; P=0.027). In quasi-experimental study, 63 participants were allocated into two groups i.e., experimental group (n=27) and control group (n=36). Before receiving pill box, the number of patients having INR within the target in control group was significantly higher than that in experimental group (P=0.031). After receiving pill box, the number of patients having INR within the target in both groups was not significantly different (P=0.272). At the beginning of the study, adherence of the experimental group was significantly lower than that of the control group (P=0.002). At the end of the study, adherence in both groups was not significantly different (P=0.812). Conclusion: Factors associated with a better control of INR were being married, having more than high school level of educational and being old case of patients. The pill box tended to improve the control of INR and adherence of warfarin.
Article Details
ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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