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KNOWLEDGE AND ATTITUDE OF MEDICAL DOCTORS ON ANTICOAGULATION THERAPY IN TERTIARY HOSPITALS IN NIGERIA
Author(s):
Theresa U Nwagha
,
Theresa U Nwagha
Affiliations:
Haematology & Immunology,University Of Nigeria Teaching Hospital,Enugu,Nigeria
Ralph Anakwue
,
Ralph Anakwue
Affiliations:
Internal medicine,University Of Nigeria Teaching Hospital,Enugu,Nigeria
Oju Ukpabi
,
Oju Ukpabi
Affiliations:
Internal medicine,Abia state Teaching Hospital,Umuahia,Nigeria
E Onwubuya
,
E Onwubuya
Affiliations:
Internal medicine,Nnamdi Azikiwe Teaching Hospital Nnewi,Awka,Nigeria
N Obeka
,
N Obeka
Affiliations:
Internal medicine,Federal Medical center, Abakiliki,Nigeria
Innocent Okoye
,
Innocent Okoye
Affiliations:
Internal medicine,Amaku Specialist hospital,Awka,Nigeria
Ben Azubuike
Ben Azubuike
Affiliations:
Internal medicine,Amaku Specialist hospital,Awka,Nigeria
(Abstract release date: 05/18/17) EHA Library. Nwagha T. 05/18/17; 182926; PB2213
Prof. Theresa Nwagha
Prof. Theresa Nwagha
Contributions
PDF Abstract
Abstract

Abstract: PB2213

Type: Publication Only

Background
Thromboembolic and hypercoagulable diseases are common life-threatening but treatable problems in hospital practice. The most effective and economical approach to decreasing the burden of VTE is to prevent the development of DVT and PE in patients especially in acutely ill hospitalized medical patients. Health care providers in Nigeria may have significant gaps in their anticoagulation knowledge that could affect their decision to prescribe anticoagulation therapy as there are no national guidelines on the use of anticoagulation in Nigeria.

Aims
The purpose of this present study was to examine the knowledge and attitude of medical doctors on anticoagulation in tertiary hospitals in Nigeria.

Methods
The present study is a multicentre survey of the use of anticoagulants among clinicians in South East Nigeria. A pretested questionnaire was administered to clinicians in six tertiary hospitals in the south-east of Nigeria. The following institutions participated in the survey: University of Nigeria Teaching Hospital Enugu, Federal Medical Centre, Abakaliki, Federal Medical Centre Umuahia, Abia State Teaching Hospital, Aba, Amaku Specialist Hospital, Awka and Nnamdi Azikiwe Teaching Hospital, Nnewi. The Likert scale which is in grades from one to five: 1 strongly disagree, 2 disagree,3 neutral,4agree,5 strongly disagree was used. To determine the agreement degree three levels were identified (high medium and low).

Results
There were 528 respondents. 378 of them were males (71.6%) and 150 were females (28.4%). 31.1% of the respondents, were junior residents and the consultants represented only 20.6% of the respondents. Most of the respondents,189 (35.8%) had less than 5 years clinical experience while the least of the respondents (8.7 % ) had between 16-20 years clinical experience

We observed that most respondents irrespective of their job grades didn’t know about Fondaparinux and the DOAC (except those in the specialist -registrar job grades) as the overall p = (0.000),< 0.05 and were significant. We also observed that responses were divided on malignancy as an indication for anticoagulation. The overall P=0.002, <0.05 and was significant. The p valve for other indications for anticoagulation > 0.05 and was not significant.
The majority knew of prothrombin test and p valve was 0.03, less than alpha value of 0.05 and was significant. On the contrary, Majority does not know about anti-Xa assay, p-value =0.02, < 0.05, was also significant. Their responses on the difference between the conventional anticoagulant; warfarin and the DOACs are presented in table 6. Their affirmative response on the mode of action as one of the differences showed a p =0.000, < 0.05, was significant. On the contrary, the non-affirmative response to drug and food interaction, p = 0.03, was also significant. (See tables 1-6)
Based on results of the statement analysis as summarized in table 7, the variables were ranked according to the value of their mean. All except one variable had p-values of <0.05. The statement “Do you think anticoagulation therapy/prophylaxis is clinically important” had the highest mean of 4.60 and had a high degree of agreement. The statement “Should hospital inpatient with >3days admission routinely receive anticoagulation?” had the lowest mean of 2.27 with a p-value of 0.015 had a low degree of agreement.

Conclusion
There is a need to upscale knowledge attitude and practice of the use anticoagulation agents especially the NOACs through well-articulated CME educational activities. A limitation of this study is the relatively small number of study participants and some subspecialties that were not reflected in this survey.

Session topic: 34. Thrombosis and vascular biology

Keyword(s): Anticoagulation, Anticoagulants

Abstract: PB2213

Type: Publication Only

Background
Thromboembolic and hypercoagulable diseases are common life-threatening but treatable problems in hospital practice. The most effective and economical approach to decreasing the burden of VTE is to prevent the development of DVT and PE in patients especially in acutely ill hospitalized medical patients. Health care providers in Nigeria may have significant gaps in their anticoagulation knowledge that could affect their decision to prescribe anticoagulation therapy as there are no national guidelines on the use of anticoagulation in Nigeria.

Aims
The purpose of this present study was to examine the knowledge and attitude of medical doctors on anticoagulation in tertiary hospitals in Nigeria.

Methods
The present study is a multicentre survey of the use of anticoagulants among clinicians in South East Nigeria. A pretested questionnaire was administered to clinicians in six tertiary hospitals in the south-east of Nigeria. The following institutions participated in the survey: University of Nigeria Teaching Hospital Enugu, Federal Medical Centre, Abakaliki, Federal Medical Centre Umuahia, Abia State Teaching Hospital, Aba, Amaku Specialist Hospital, Awka and Nnamdi Azikiwe Teaching Hospital, Nnewi. The Likert scale which is in grades from one to five: 1 strongly disagree, 2 disagree,3 neutral,4agree,5 strongly disagree was used. To determine the agreement degree three levels were identified (high medium and low).

Results
There were 528 respondents. 378 of them were males (71.6%) and 150 were females (28.4%). 31.1% of the respondents, were junior residents and the consultants represented only 20.6% of the respondents. Most of the respondents,189 (35.8%) had less than 5 years clinical experience while the least of the respondents (8.7 % ) had between 16-20 years clinical experience

We observed that most respondents irrespective of their job grades didn’t know about Fondaparinux and the DOAC (except those in the specialist -registrar job grades) as the overall p = (0.000),< 0.05 and were significant. We also observed that responses were divided on malignancy as an indication for anticoagulation. The overall P=0.002, <0.05 and was significant. The p valve for other indications for anticoagulation > 0.05 and was not significant.
The majority knew of prothrombin test and p valve was 0.03, less than alpha value of 0.05 and was significant. On the contrary, Majority does not know about anti-Xa assay, p-value =0.02, < 0.05, was also significant. Their responses on the difference between the conventional anticoagulant; warfarin and the DOACs are presented in table 6. Their affirmative response on the mode of action as one of the differences showed a p =0.000, < 0.05, was significant. On the contrary, the non-affirmative response to drug and food interaction, p = 0.03, was also significant. (See tables 1-6)
Based on results of the statement analysis as summarized in table 7, the variables were ranked according to the value of their mean. All except one variable had p-values of <0.05. The statement “Do you think anticoagulation therapy/prophylaxis is clinically important” had the highest mean of 4.60 and had a high degree of agreement. The statement “Should hospital inpatient with >3days admission routinely receive anticoagulation?” had the lowest mean of 2.27 with a p-value of 0.015 had a low degree of agreement.

Conclusion
There is a need to upscale knowledge attitude and practice of the use anticoagulation agents especially the NOACs through well-articulated CME educational activities. A limitation of this study is the relatively small number of study participants and some subspecialties that were not reflected in this survey.

Session topic: 34. Thrombosis and vascular biology

Keyword(s): Anticoagulation, Anticoagulants

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