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Washington, DC—According to new data
released by SOS Rx, a project of the National Consumers League (NCL),
the 4 million Americans taking prescription blood thinners to
prevent stroke,
blood clot formation, and other serious events face complex
health problems and – to avert life-threatening events - need
more help managing these volatile medications.
Despite decades of use, medically necessary blood thinners are
challenging drugs.
They are difficult to manage, require frequent patient
monitoring, and can interact dangerously with other medications,
herbal supplements, vitamins, and foods. Telling patients of the
drugs’ dangers isn’t always enough – or the best approach.
According to the patient survey, the vast majority of
patients surveyed have
experienced adverse reactions to blood thinners, but about half
admitted they haven’t done anything to change their behavior.
On behalf of the SOS Rx (Senior
Outpatient Medication Safety)
Coalition, NCL commissioned Harris Interactive®
to conduct three surveys - one each of patients taking oral
blood thinners; caregivers who look after patients taking these
medications; and physicians who frequently prescribe the drugs.
The results in this release are from the patient survey only.
“The results are
disturbing,” said Linda Golodner, NCL President. “Consumers who
take blood thinners without direct involvement from health care
providers are walking a thin line between positive benefits and
life-threatening health risks. This new research should serve as
a clarion call for patients to make sure they get the care and
answers they need from their health care providers. This
includes doctors, nurses, pharmacists, and all other people who
care for and treat patients on blood thinners.”
The survey results
suggest the serious need for patient education and improving
communication among those involved in the medication’s
administration: health care providers, caregivers, and patients
themselves. NCL has created a new Web site,
www.mybloodthinner.org, and tools to serve as additional
resources for consumers, providers, and caregivers. By
directing patients and caregivers to ask key questions of
providers, and prompting providers to anticipate those
questions, the Coalition hopes to drive safer use.
“The
Agency for Healthcare Research and Quality
applauds the work of the
SOS Rx Coalition in its new patient education campaign on the
safe use of oral anticoagulants,” said AHRQ Director Carolyn M.
Clancy, M.D. “AHRQ has funded a number of studies on the safe
use of warfarin that underscore the importance of involving
health care providers and their patients in efforts to use
medications safely. We are pleased to be part of this important
SOS Rx Coalition initiative.”
Survey and Research Highlights
Vulnerable Population. For patients who take oral blood
thinners, serious and multiple health problems are a common
threat. Fifty-nine percent of respondents describe themselves as
suffering from poor or fair health. Many suffer multiple health
conditions (54 percent have four or more identified conditions)
and are heavy health care system users. In the past year, 41
percent of patient respondents saw at least four doctors in
addition to their regular doctor, and 40 percent visited an
emergency room at least once. The average respondent takes 7
prescription drugs on a regular or ongoing basis.
Knowledge/Behavior Disconnects.
Despite patients’ perceptions of generally
understanding things they should and should not do when taking a
blood thinner, actual behavior could be improved.
While 80 percent of
respondents recognized the importance of talking to their doctor
or pharmacist before taking an OTC medication or dietary
supplement, fewer than half (46 percent) say they actually do
so. Similar disconnects exist between knowing the importance of
reminding their pharmacist they are on a blood thinner (78
percent) and actually doing so (49 percent).
Warning Signs Ignored.
Although the vast majority (93 percent) of
respondents who have been taking these types of medications
reported experiencing some kind of adverse reaction to their
blood thinner - such as bruising, bleeding, and dizziness - 51
percent say they have done nothing to alter behavior. More than
a third (37 percent) of those who experienced side effects did
not even inform their doctor.
Patients Stranded.
Many patients surveyed report doctors don’t offer
reminders about lab tests (28 percent) or appointments (14
percent) and sometimes fail to provide feedback on test results
(17 percent). Many are left alone to deal with treatment: about
a third said their doctor has not asked whether they are having
problems (31 percent) and find it difficult to contact their
doctors by phone (33 percent).
Blood Test Goals: Improved Communication Needed.
Regular
blood testing is needed to determine exactly what treatment
dosage an individual needs. The test result is the patient’s PT
or INR number, the desired range for which is generally between
2 and 3. Despite the importance of this lab value, the survey
shows that a fifth (21 percent) of
respondents were not sure what their PT/INR number should be,
and 28 percent of those who have been told what it should be are
not sure what it was at their last blood test.
Education Opportunities Abound. Unfortunately, physicians and other
health care providers could do a better job helping patients
understand the rules that accompany a blood thinner
prescription. According to some respondents who have been taking
oral anticoagulants: doctors failed to instruct them about
special dietary considerations (21 percent); did not explain
possible interactions with other medications and dietary
supplements (19 percent); did not tell them about possible side
effects (17 percent); and did not tell them what symptoms to
watch for and when to seek further care or treatment (15
percent).
For complete survey data,
including caregivers’ and physicians’ perspectives, as well as
focus group research and background about oral anticoagulants,
visit
www.mybloodthinner.org
About the survey
Harris Interactive conducted surveys with patients, caregivers,
and physicians about the use of oral anticoagulants on behalf of
the National Consumers League. All three surveys were conducted
online within the United States. For the patients’ survey, 426
adults ages 30 and over who have been on an oral anticoagulant
for at least 30 days completed the survey between April 4 and
15, 2005. For the caregivers’ survey, 109 adults 30 years of
age or older who have been taking care of a person who is on an
oral anticoagulant for at least 30 days completed the survey
between May 19 and 26, 2005. Finally, for the physicians’
survey, 101 primary care providers and cardiovascular
specialists who are treating at least 5 patients who have been
on an oral anticoagulant completed the survey between August 11
and 18, 2005. Respondents for all three surveys were from
Harris Interactive’s multimillion online panel of respondents (HPOL).
Data for all three surveys were not weighted and therefore are
only representative of those patients, caregivers, primary care
providers and cardiovascular specialists surveyed. NCL thanks
AstraZeneca for an unrestricted educational grant that made the
survey possible.
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