Introduction: Previous research has demonstrated that patients with atrial fibrillation (AF) have limited knowledge of AF, stroke and oral anticoagulant (OAC) treatment. This analysis assessed the effect of educational level on stroke knowledge, AF perception, concern about stroke, OAC treatment preferences and adherence.
Methods: This was a cross-sectional, prospective survey of 936 adult patients (mean (SD) age 54.3 (16.6) yrs; 37.2% female) with AF on OACs in the USA, Canada, Germany, France and Japan. Three groups were included: AF with recent stroke (≤ 6 m); new onset AF (≤ 6 [ ≤ 12 m in Japan]) without recent stroke; established AF (7-24m [1-3yrs in Japan]) without recent stroke. Open-ended questions determined stroke knowledge, assessed according to a predefined scoring system. Patients were grouped according to educational level: no school-leaving certificate (low), high school diploma, community college and university/technical college.
Results: Stroke knowledge was similar in all patients regardless of educational level.
A greater proportion of patients with college education were ‘always’ or ‘often concerned’ about stroke, whereas a greater proportion of those with low levels of education were ‘never concerned’ about stroke (or didn’t know).
Educational level had no effect on self-reported OAC adherence or patient preference to be involved in OAC treatment decisions. Patients with no school leaving certificate perceived taking medication (all drugs) as a ‘major burden’ (25.9%), while significantly more patients with college/university education did not view taking medication as burdensome (38.5% and 50.4% versus 37.0%, respectively; Table).
Conclusions: Education influenced patients’ perceptions of the seriousness of AF, frequency of concern about stroke and perceived burden of medication. Educational attainment did not affect level of stroke knowledge, OAC adherence and desire to be involved in OAC treatment decisions.