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Keywords:

  • adherence;
  • anticoagulation;
  • cardiovascular;
  • INR;
  • long-term care;
  • nursing;
  • patient;
  • warfarin

Aims and objectives.  To explore adherence with health regimens and factors influencing it of patients on warfarin therapy.

Background.  Adherence to health regimens is a crucial factor for patients on long-term warfarin therapy. Approximately 50% of patients with chronic conditions have good adherence. This study covers a more extensive perspective on patients’ adherence to warfarin therapy than earlier studies, which focus mainly on adherence to medication.

Design.  A descriptive cross-sectional design was used.

Methods.  A survey of 139 patients was conducted in 2008. A self-reported Adherence of people with Chronic Disease Instrument questionnaire was used to assess adherence to health regimens and factors influencing it. Chi-squared test, Mann–Whitney U-test and Kruskal–Wallis test were used to analyse the data.

Results.  About half (51%) of the respondents complied well with health regimens, while 74% had good adherence with warfarin therapy. Females had better adherence than males. The highest degree of adherence was reported by patients who had venous thrombosis and whose therapy had lasted from one to three years. Patients who adhered well to warfarin therapy also had good adherence with other health regimens such as diet, exercise, attending international normalised ratio tests and collaboration with health care. There was also a statistically significant difference between adherence to health regimens and motivation and sense of normality.

Conclusions.  Good adherence to health regimens had an impact on good adherence to warfarin therapy. Collaboration with health care professionals, motivation and patients’ sense of normality are crucial factors to improve adherence.

Relevance to clinical practice.  To improve adherence to health regimens, collaboration between patients and health professionals should be strengthened. Furthermore, discussion with patients can aid in understanding problems of motivation and help health care professionals provide support. Tailoring treatment and care as a part of patients’ life helps them gain a sense of normality and improve adherence.