Assessment of the attitude, awareness and practice of periprocedural warfarin management among health care professional
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Assessment of the attitude, awareness and practice of periprocedural warfarin management among health care professional in Qatar. A cross sectional survey Islam Eljilany1 · Ahmed El‑Bardissy2 · Arwa Nemir1 · Abdel‑Naser Elzouki3,4 · Ihab El Madhoun5,6 · Daoud Al‑Badriyeh1 · Hazem Elewa1
© The Author(s) 2020
Abstract It is estimated that 10–15% of oral anticoagulant (OAC) patients, would need to hold their OAC for scheduled surgery. Especially for warfarin, this process is complex and requires multi-layer risk assessment and decisions across different specialties. Clinical guidelines deliver broad recommendations in the area of warfarin management before surgery which can lead to different trends and practices among practitioners. To evaluate the current attitude, awareness, and practice among health care providers (HCPs) on warfarin periprocedural management. A multiple-choice questionnaire was developed, containing questions on demographics and professional information and was completed by187 HCPs involved in warfarin periprocedural management. The awareness median (IQR) score was moderate [64.28% (21.43)]. The level of awareness was associated with the practitioner’s specialty and degree of education (P = 0.009, 0.011 respectively). Practice leans to overestimate the need for warfarin discontinuation as well as the need for bridging. Participants expressed interest in using genetic tests to guide periprocedural warfarin management [median (IQR) score (out of 10) = 7 (5)]. In conclusion, the survey presented a wide variation in the clinical practice of warfarin periprocedural management. This study highlights that HCPs in Qatar have moderate awareness. We suggest tailoring an educational campaign or courses towards the identified gaps. Keywords Survey · Warfarin · Bridging · Periprocedural management · Qatar
Highlights • Warfarin periprocedural management is complex and
* Hazem Elewa [email protected] 1
College of Pharmacy, QU Health, Qatar University, Doha, Qatar
2
Department of Pharmacy, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
3
Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
4
College of Medicine, Qatar University & Weill Cornell Medical College- Qatar, Doha, Qatar
5
Department of Medicine, Al Wakra Hospital Hamad Medical Corporation, Al Wakra, Qatar
6
Weill Cornell Medical College, Al Wakra, Qatar
requires multiple risk assessments and synchronized decisions. • Clinical guidelines deliver broad recommendations in the area of warfarin management before surgery which can lead to different trends and practices among practitioners. • This survey evaluates the current attitude, awareness, and practice among health care providers (HCPs) on warfarin periprocedural management. • The project presented a wide variation in the clinical practice of warfarin periprocedural management and moderate awareness.
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Introduction Oral anticoagulants (OAC) have been used for years in the treatment and prevention o
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