Grant: Travel Awards - Institute Community Support

Background: Patients with atrial fibrillation (AF) frequently do not take their medications as prescribed. Poor patient understanding of their disease and medications has been associated with poor adherence. The aim of this systematic review was to characterize the published literature about AF patients' knowledge to identify knowledge gaps and misconceptions, to inform AF patient education strategies. Methods: We searched relevant databases for studies that assessed AF patients' knowledge about their condition (and the associated risk of stroke) and medications. From each included study we extracted the proportion of participants who provided correct answers to the questions asked about their condition, medications or risk of stroke. We classified data from related questions into categories called knowledge domains. Statistical methods were used to calculate pooled mean proportion correct answers for each knowledge domain. A domain was considered a knowledge gap if the pooled mean proportion of participants who demonstrated knowledge of it was less than or equal to 50%. Results: Twenty-one studies met the inclusion criteria. We found that AF patients are likely to have significant knowledge gaps in clinically important areas. Atrial Fibrillation- and stroke-related knowledge gaps and misconceptions included: AF can be asymptomatic, AF can predispose to heart failure, women are at a higher risk of stroke, the definition of ischemic stroke, and patients' awareness of their diagnosis. Medication-related knowledge gaps were identified in the following domains: anti-thrombotic-drug interactions, anti-thrombotic-food interactions, vitamin K content of foods, the term "INR" and its interpretation, and the required actions in case of a missed dose. Conclusion: Our results show that there are many clinically important gaps in AF patients' knowledge, which could serve as targets for AF patient education strategies.