Effectiveness of a Nurse-Led Education Programme on Knowledge, Adherence and Complications of Oral Anticoagulation Therapy among Patients: A Pilot Study

Oral anticoagulation therapy is essential for preventing and treating thromboembolic complications. However, inadequate knowledge and poor adherence may increase the risk of adverse outcomes. This pilot study aimed to assess the effectiveness of a nurse-led education program on knowledge, adherence, and complications of oral anticoagulation therapy among patients in a selected hospital in Chennai. Methods: A quantitative, pre-experimental, one-group pretest-posttest design with repeated assessments was used for this pilot study. We selected ten patients receiving oral anticoagulation therapy using non-probability purposive sampling at Sri Ranga Heart Centre. Baseline data were collected on day 1 using a semi-structured demographic and clinical questionnaire, a 20-item structured knowledge questionnaire, the Modified Morisky Medication Adherence Scale, and a 10-item complications checklist. A nurse-led education programme consisting of video-assisted teaching and individual counselling was provided on day 1. Post-test 1 was conducted on day 15 by telephone and post-test 2 on day 30 during follow-up. Data were analysed using frequency, percentage, mean, standard deviation, paired t-test, repeated-measures ANOVA, and Karl Pearson’s correlation coefficient. Results: At baseline, all participants (100%) had inadequate knowledge. After the intervention, 70% had adequate knowledge and 30% had moderately adequate knowledge at post-test 1, while all participants (100%) had adequate knowledge at post-test 2. High adherence increased from 40% at pretest to 90% at post-test 1 and 100% at post-test 2. Low-level complications increased from 60% at pretest to 70% and 80% at post-test 1 and post-test 2, respectively, while moderate-level complications decreased from 40% to 30% and 20%. Repeated-measures ANOVA showed significant differences across the three assessments for knowledge (F=355.26, p=0.0001), adherence (F=11.54, p=0.004), and complications (F=10.367, p=0.002). Post-test 2 knowledge showed a weak positive, non-significant correlation with adherence (r=0.229, p=0.525) and no correlation with complications (r=0.000, p=1.000). Conclusion: The pilot findings indicate that the nurse-led education program was feasible and was associated with improvement in knowledge and adherence and a reduction in the complications score over the three assessments. The findings support proceeding to the main study, while the small pilot sample requires cautious interpretation.