Evaluation of a pre-consultation questionnaire on patient knowledge concerning oral anticoagulant therapy: The EDUCONSULT randomized trial

Background Complications of anticoagulants are correlated with morbidity, mortality and healthcare costs. Improving patient knowledge might help alleviate this burden. Methods This randomized controlled trial studied the impact of a dedicated 13 item self-administered pre-consultation questionnaire on patient knowledge concerning their oral anticoagulation therapy (OAT), compared to usual care. The primary endpoint was total score on the post-consultation questionnaire. Secondary endpoints included analysis of adherence, anxiety and predictive factors of improvement of knowledge. Results In total, 196 patients were included and randomized into two comparable groups of high risk profile with a median age of 68 years old and mean CHADS2 score of 3.22 (± 1.7). Patients were mostly treated by vitamin K antagonists (63.8%) and a trial fibrillation was the main indication of treatment (74.5%). Patients having filled a pre-consultation questionnaire had an improved mean knowledge score compared to standard care (17.13/22 vs. 13.66/22; P P P P P  = 0.0144), a low level of adherence ( P  = 0.0262) and a HAS-BLED score ≤ 1 ( P  = 0.0254) were significantly associated to very low results (less than 50% of correct answers). Levels of anxiety about treatment were similar in the two groups. Conclusion A user-friendly pre-consultation questionnaire was found to be an effective tool to improve patient knowledge concerning OAT in a real-life setting. This educational strategy may be useful in reducing future complications by targeting specific information to patient according to their level of knowledge.