Non-adherence is highlighted as one of the main contributors to the occurrence of adverse events and negative clinical outcomes in patients treated with warfarin. The aim was to examine knowledge on warfarin, medication belief, depression, and self-efficacy as factors influencing medication adherence for anticoagulation control. This was a cross-sectional study. The participants in this study were patients who visited an outpatient clinic of cardiovascular surgery to administer anticoagulants after mechanical valve replacement surgery at a tertiary hospital in Seoul. Responses of 154 participants on questionnaires were analyzed from 10 September to 26 December 2020. Multiple regression analyses were performed to assess the factors influencing medication adherence among the patients with anticoagulation control. Factors influencing medication adherence were consuming warfarin for 3 to 5 years, awareness of target prothrombin time international normalized ratio, knowledge of warfarin, and depression. Medication beliefs and self-efficacy had no significant influence on medication adherence. The most important factors associated with medication adherence in patients with mechanical heart valves were knowledge about warfarin and depression. In the control of oral anticoagulants that require continuous management, education and providing accurate guidance is more important than personal preferences. Clinical nurses should facilitate educational programs tailored to the characteristics of the patient, including their purpose and method of taking warfarin, specific diets, their knowledge on warfarin’s interaction with other drugs, symptoms of adverse events, and self-management. In addition, healthcare providers should check whether warfarin therapy is being controlled by evaluating medication adherence and depression levels among patients.

中文翻译：

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影响机械心脏瓣膜患者服用华法林药物依从性的因素：华法林知识、药物信念、抑郁和自我效能的作用

不依从性被认为是华法林治疗患者发生不良事件和负面临床结果的主要原因之一。目的是检查关于华法林、药物信念、抑郁和自我效能的知识，作为影响抗凝控制药物依从性的因素。这是一项横断面研究。这项研究的参与者是在首尔一家三级医院进行机械瓣膜置换手术后前往心血管外科门诊施用抗凝剂的患者。对2020年9月10日至12月26日期间154名参与者的问卷调查进行了分析。进行多元回归分析以评估影响抗凝控制患者药物依从性的因素。影响用药依从性的因素包括服用华法林3至5年、对目标凝血酶原时间国际标准化比率的认识、对华法林的了解和抑郁症。用药信念和自我效能对用药依从性没有显着影响。与机械心脏瓣膜患者的药物依从性相关的最重要因素是对华法林和抑郁症的了解。在需要持续管理的口服抗凝药的控制中，教育和提供准确的指导比个人偏好更重要。临床护士应促进针对患者特征的教育计划，包括服用华法林的目的和方法、具体饮食、华法林与其他药物相互作用的知识、不良事件症状和自我管理。此外，医疗保健提供者应通过评估患者的药物依从性和抑郁水平来检查华法林治疗是否受到控制。