The Effect of Nurse Home-Support Program on Self-Management of Patients Receiving Oral Anticoagulation (Warfarin) Therapy

AIM: Warfarin, which is widely used for preventing thromboembolic events, can cause major and minor side effects. The aim of this trial is to evaluate the effect of nurse home-support program on self-management of patients receiving warfarin therapy. METHOD: A randomized, controlled trial was conducted using 36 selected and eligible patients who had 12-month home-visit follow-ups. The bleeding risk score, potential and preventable warfarin-related complications, patients’ self-management behaviors, and anticoagulation satisfaction were examined. Data analyses were performed using parametric and nonparametric tests, split-plot analysis of variance, multiple regression analysis, and Bland and Altman plots test. RESULTS: The bleeding risk score was an effective variable for assessing patient satisfaction (p<0.05). The self-management group demonstrated decreased bleeding risk at the end of the trial. The Duke Anticoagulation Satisfaction Scale mean score represents a statistically significant improvement in the self-management group (p<0.05). Patients’ self-management behaviors improved significantly in the self-management group compared to the control group (p<0.05). The number of international normalized ratio values within the target range was significantly higher in the self-management group (174/432) than in the control group (82/432). The self-management group showed significant reductions in both thromboembolic events. CONCLUSION: This trial demonstrated evidence that use of nursing home care is effective in developing self-management behaviors, improving patient satisfaction, and preventing complications in patients receiving warfarin therapy. This model could be easily adopted and implemented by home care services and health organizations.