Videos have been helping Australians of all ages get the best possible results from their blood thinners as part of a new trial by researchers from Curtin University and Sir Charles Gairdner Hospital.
Oral anticoagulants are widely prescribed in general practice, yet clinicians continue to face practical issues in managing anticoagulant therapy, such as nonmajor bleeding, changes in anticoagulant therapy, patients’ individual history, and adherence.
The videos give patients starting on oral anticoagulants practical tips on how to take their medicine safely and correctly, keep track of their own health, work with their health professionals and better protect themselves against injuries.
Lead researcher Dr Leanne Chalmers, from Curtin Medical School, said that blood thinners (which don’t actually thin the blood) are taken by Australians of all ages to prevent and treat blood clots.
“The reasons for taking oral anticoagulants include a fast, irregular heart rate (atrial fibrillation) and heart valve replacement surgery, both of which are more common in older Australians; and blood clots in the legs (deep vein thrombosis) and lungs (pulmonary embolism), which can occur in people of any age, including travellers, people after surgery and people with conditions that increase the stickiness of their blood,” Dr Chalmers said.
“Oral anticoagulants are very effective, but people need to understand how to use them correctly to help balance their chances of bleeding and clotting.”
For example, research from France showed that in ambulatory care in 2020, anticoagulants were involved in 12% of suspected adverse drug reactions and were the leading cause of emergency department admission for such reactions – because of bleeding.
The videos specifically address the vitamin K antagonist (VKA) warfarin, the primary treatment for blood clots since 1954, and direct oral anticoagulants (DOACs), which entered the Australian market in 2013.
Warfarin (originally introduced as a rat poison in 1948) is affected by a range of factors such as diet and concomitant drugs, and while the new DOACs have relatively stable pharmacokinetics that remove the need for regular monitoring and dose adjustment, their use has also been associated with an increased risk of specific subtypes of bleeding episodes.
In previous research, Dr Chalmers showed that patients taking DOACs reported sub-optimal knowledge regarding their anticoagulant therapy, compared to patients taking warfarin – and even pharmacists reported being less confident in their knowledge of DOACs than VKAs.
“Nurses and pharmacists currently do a terrific job in providing face-to-face and written information to people starting anticoagulants, but we hope offering patients a video to watch as well will allow them greater flexibility about when and how they take in this important information,” Dr Chalmers said.
“There are many simple tips for helping people taking blood thinners make the most of their medicines, such as remembering to take them regularly every day, watching themselves for signs of unwanted bleeding, working with their health professionals, and preventing injuries by using soft toothbrushes, wearing gloves while gardening, and using non-slip bathmats in the shower.”
Due to COVID considerations, the videos were shared via a YouTube link for patients to watch on their own devices, and participants were encouraged to share the videos with their family or carers to support their personal care networks.
The trial was supported by the Curtin School of Pharmacy and Biomedical Sciences EMCA Program and Dr Chalmers and her team presented their research at the National Medicines Symposium 2022, hosted virtually by NPS MedicineWise on 31 May 2022.