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Clinicians-related determinants of anticoagulation therapy and prophylaxis in Nigeria
Raphael Anakwue1, Theresa Nwagha2, Ogba J Ukpabi3, Ndudim Obeka4, Emmanuel Onwubuya5, Uwa Onwuchekwa6, Benjamin Azubuike7, Innocent Okoye8
1 Department of Medicine, Pharmacology/Therapeutics, University of Nigeria, Enugu Campus, Nigeria
2 Department of Haematology and Immunology, Thrombosis and Bleeding Unit, University of Nigeria Enugu Campus/University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu, Nigeria
3 Department of Medicine, Federal Medical Centre, Umuahia, Nigeria
4 Department of Internal Medicine, Federal Teaching Hospital Abakaliki, Abakaliki, Nigeria
5 Department of Internal Medicine, Abia State University Teaching Hospital, Aba, Nigeria
6 Department of Medicine, Nnamdi Azikiwe University Teaching Hospital, Nnewi, Nigeria
7 Department of Medicine, Federal Medical Centre, Owerri, Nigeria
8 Department of Medicine, Chukwuemeka Odumegwu Ojukwu Teaching Hospital, Amaku Awka, Nigeria
Correspondence Address:
Theresa Nwagha
Department of Haematology and Blood Transfusion, Thrombosis and Bleeding Unit, University of Nigeria Enugu Campus/University of Nigeria Teaching Hospital, Ituku-Ozalla, Enugu
Nigeria
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/aam.aam_35_17
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Background: Thromboembolic and hypercoagulable diseases are common life-threatening but treatable problems in hospital practice. Fortunately, anticoagulation is an efficacious management practice indicated for arterial, venous, and intracardiac thromboembolism. Clinicians in developing countries may have gaps in their knowledge of anticoagulation therapy/prophylaxis which could affect their clinical decision. Objectives: The study examined the knowledge and attitude of clinicians to anticoagulation therapy/prophylaxis in some tertiary hospitals in Nigeria. Methodology: The study was a multicenter survey. A pretested questionnaire was administered to clinicians in six tertiary hospitals in Southeast Nigeria. Results: A total of 528 questionnaires were returned by 419 (79.4%) residents and 109 (20.6%) consultants. We observed significant abysmal knowledge and lack of awareness of direct oral anticoagulants (DOACs) among most respondents irrespective of their job grades (P = 0.02, odds ratio [OR] 0.59, 95% confidence interval [CI] 0.38–0.90). Their knowledge of anti-Xa assay as laboratory monitoring tool was also significantly inadequate (P = 0.001, OR 0.23, 95% CI 0.10–0.51). On statement analysis on their attitude to anticoagulation therapy/prophylaxis, “Do you think anticoagulation therapy/prophylaxis is clinically relevant” had the highest mean of 4.60, P = 0.01, and a high degree of agreement; while “Should hospital inpatient with > 3 days admission routinely receive anticoagulation/prophylaxis?” had the lowest mean of 2.27, P = 0.02, and a low degree of agreement. Conclusion: There is the need to upscale knowledge of anticoagulation agents and an attitude change to anticoagulation therapy/prophylaxis, especially on the DOACs through continuing medical education activities in emerging countries such as Nigeria.
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