Assessment of the attitude, awareness and practice of periprocedural warfarin management among health care professional in Qatar. A cross sectional survey

J Thromb Thrombolysis. 2020 Nov;50(4):957-968. doi: 10.1007/s11239-020-02111-w.

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: Bridging; Periprocedural management; Qatar; Survey; Warfarin.

MeSH terms

  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects
  • Blood Loss, Surgical / prevention & control*
  • Cross-Sectional Studies
  • Female
  • Health Knowledge, Attitudes, Practice
  • Health Personnel* / education
  • Health Personnel* / standards
  • Health Personnel* / statistics & numerical data
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Qatar
  • Surgical Procedures, Operative / adverse effects*
  • Surgical Procedures, Operative / methods
  • Warfarin* / administration & dosage
  • Warfarin* / adverse effects
  • Withholding Treatment*

Substances

  • Anticoagulants
  • Warfarin