Effect of video-assisted counseling versus traditional counseling on patient comprehension of prescribed direct oral anticoagulants

ABSTRACT

Introduction: Although direct oral anticoagulants (DOACs) are considered high-risk medications, many patients discharged on a DOAC do not receive adequate counseling. The use of technology (e.g., educational videos, mobile devices) may be able to assist with DOAC counseling and reduce healthcare resources. The objective of this study was to compare the impact of video-assisted counseling (VAC) versus traditional counseling (TC) by a pharmacist on DOAC comprehension in patients being discharged from an inpatient cardiology service. Research Question or Hypothesis: VAC and TC by a pharmacist will result in similar patient comprehension of their prescribed DOAC. Study Design: Prospective, randomized, open-label, parallel-group study Methods: Counseling transcripts (for both groups) and animated videos with voiceover and images (VAC group only) were created for DOAC counseling. Patients were randomized to the VAC or TC group. Patient comprehension was assessed before and after counseling with the validated Knowledge Of Direct Oral Anticoagulants (KODOA)-test on a mobile tablet device. A mixed-model ANOVA was used to analyze differences in KODOA test scores by treatment and time. The goal was to enroll 40 patients. Results: A total of 15 patients were enrolled;7 in the VAC group and 8 in the TC group. Enrollment was halted due to Coronavirus disease- 2019. Mean KODOA score increased from 9.1 to 11.5 (out of 15) in the TC group and from 9.3 to 11.6 in the VAC group (F = 51.87, P < 0.0001, Eta-squared = 0.80). The mean KODOA test score did not differ between groups according to type of counseling intervention (P = 0.74). Conclusion: KODOA scores after counseling were significantly higher than before counseling in both groups. VAC resulted in similar patient comprehension of their prescribed DOAC as TC. VAC may be a viable alternative to TC while saving resources (e.g., pharmacist time and salary).