Survey: Patients Taking Blood Thinners Need Extra Help from Their Providers

Patient Safety Group Releases Comprehensive Data Showing Disconnect Between Blood Thinner Safety Knowledge and Use; New Program Launched to Help Patients, Caregivers, Providers Bridge Gaps

Embargoed for Immediate Release: May 31, 2006

Contact: National Consumers League Communications Department media@nclnet.org, 202-835-3323

 

Washington, DC—According to new data released by SOS Rx, a project of the National Consumers League (NCL), the 4 million Americans taking prescription blood thinners to prevent stroke*, blood clot formation, and other serious events face complex health problems and -- to avert life-threatening events -- need more help managing these volatile medications. Despite decades of use, medically necessary blood thinners are challenging drugs. They are difficult to manage, require frequent patient monitoring, and can interact dangerously with other medications, herbal supplements, vitamins, and foods. Telling patients of the drugs’ dangers isn’t always enough -- or the best approach. According to the patient survey, the vast majority of patients surveyed have experienced adverse reactions to blood thinners, but about half admitted they haven’t done anything to change their behavior.

On behalf of the SOS Rx (Senior Outpatient Medication Safety) Coalition, NCL commissioned Harris Interactive® to conduct three surveys -- one each of patients taking oral blood thinners; caregivers who look after patients taking these medications; and physicians who frequently prescribe the drugs. The results in this release are from the patient survey only.

“The results are disturbing,” said Linda Golodner, NCL President. “Consumers who take blood thinners without direct involvement from health care providers are walking a thin line between positive benefits and life-threatening health risks. This new research should serve as a clarion call for patients to make sure they get the care and answers they need from their health care providers. This includes doctors, nurses, pharmacists, and all other people who care for and treat patients on blood thinners.”

The survey results suggest the serious need for patient education and improving communication among those involved in the medication’s administration: health care providers, caregivers, and patients themselves. NCL has created a new Web site, www.mybloodthinner.org, and tools to serve as additional resources for consumers, providers, and caregivers.  By directing patients and caregivers to ask key questions of providers, and prompting providers to anticipate those questions, the Coalition hopes to drive safer use.

“The Agency for Healthcare Research and Quality applauds the work of the SOS Rx Coalition in its new patient education campaign on the safe use of oral anticoagulants,” said AHRQ Director Carolyn M. Clancy, M.D. “AHRQ has funded a number of studies on the safe use of warfarin that underscore the importance of involving health care providers and their patients in efforts to use medications safely. We are pleased to be part of this important SOS Rx Coalition initiative.”

Survey and Research Highlights

Vulnerable Population. For patients who take oral blood thinners, serious and multiple health problems are a common threat. Fifty-nine percent of respondents describe themselves as suffering from poor or fair health. Many suffer multiple health conditions (54 percent have four or more identified conditions) and are heavy health care system users. In the past year, 41 percent of patient respondents saw at least four doctors in addition to their regular doctor, and 40 percent visited an emergency room at least once. The average respondent takes 7 prescription drugs on a regular or ongoing basis.

Knowledge/Behavior Disconnects. Despite patients’ perceptions of generally understanding things they should and should not do when taking a blood thinner, actual behavior could be improved.

While 80 percent of respondents recognized the importance of talking to their doctor or pharmacist before taking an OTC medication or dietary supplement, fewer than half (46 percent) say they actually do so. Similar disconnects exist between knowing the importance of reminding their pharmacist they are on a blood thinner (78 percent) and actually doing so (49 percent).

Warning Signs Ignored. Although the vast majority (93 percent) of respondents who have been taking these types of medications reported experiencing some kind of adverse reaction to their blood thinner - such as bruising, bleeding, and dizziness - 51 percent say they have done nothing to alter behavior. More than a third (37 percent) of those who experienced side effects did not even inform their doctor.

Patients Stranded. Many patients surveyed report doctors don’t offer reminders about lab tests (28 percent) or appointments (14 percent) and sometimes fail to provide feedback on test results (17 percent). Many are left alone to deal with treatment: about a third said their doctor has not asked whether they are having problems (31 percent) and find it difficult to contact their doctors by phone (33 percent).

Blood Test Goals: Improved Communication Needed.  Regular blood testing is needed to determine exactly what treatment dosage an individual needs. The test result is the patient’s PT or INR number, the desired range for which is generally between 2 and 3. Despite the importance of this lab value, the survey shows that a fifth (21 percent) of respondents were not sure what their PT/INR number should be, and 28 percent of those who have been told what it should be are not sure what it was at their last blood test.

Education Opportunities Abound. Unfortunately, physicians and other health care providers could do a better job helping patients understand the rules that accompany a blood thinner prescription. According to some respondents who have been taking oral anticoagulants: doctors failed to instruct them about special dietary considerations (21 percent); did not explain possible interactions with other medications and dietary supplements (19 percent); did not tell them about possible side effects (17 percent); and did not tell them what symptoms to watch for and when to seek further care or treatment (15 percent).

For complete survey data, including caregivers’ and physicians’ perspectives, as well as focus group research and background about oral anticoagulants, visit www.mybloodthinner.org

About the survey

Harris Interactive conducted surveys with patients, caregivers, and physicians about the use of oral anticoagulants on behalf of the National Consumers League.  All three surveys were conducted online within the United States.  For the patients’ survey, 426 adults ages 30 and over who have been on an oral anticoagulant for at least 30 days completed the survey between April 4 and 15, 2005.   For the caregivers’ survey, 109 adults 30 years of age or older who have been taking care of a person who is on an oral anticoagulant for at least 30 days completed the survey between May 19 and 26, 2005.  Finally, for the physicians’ survey, 101 primary care providers and cardiovascular specialists who are treating at least 5 patients who have been on an oral anticoagulant completed the survey between August 11 and 18, 2005. Respondents for all three surveys were from Harris Interactive’s multimillion online panel of respondents (HPOL). Data for all three surveys were not weighted and therefore are only representative of those patients, caregivers, primary care providers and cardiovascular specialists surveyed. NCL thanks AstraZeneca for an unrestricted educational grant that made the survey possible.

About the SOS Rx Coalition

SOS Rx (www.sosrx.org) is a collaborative coalition, convened by the National Consumers League, with support from Express Scripts (ESRX) as founding sponsor.  The Coalition is dedicated to promoting outpatient medication safety. With over 80 organizations participating, our voice is national, our actions evidence-based, and our initial focus on senior citizens.

* Source: National Institutes of Health, Jan. 2005

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Copyright 2006 SOS Rx