ELABORATION ET MISE EN ŒUVRE D’UN OUTIL D’EDUCATION THERAPEUTIQUE DU PATIENT TRAITE PAR ACENOCOUMAROL

Abstract

Introduction: Vitamin K antagonists (VKAs), particularly acenocoumarol, remain widely used for the prevention and treatment of thromboembolic diseases. However, their narrow therapeutic index, numerous drug and food interactions, and the need for regular INR monitoring require effective therapeutic patient education. The primary objective of this study was to design and develop two therapeutic education tools for patients receiving acenocoumarol: a patient care booklet and an Android mobile application, with the aim of improving patients' knowledge and promoting safer selfmanagement of anticoagulant therapy. Materials and Methods: This work was conducted in three phases. First, an extensive literature review based on international guidelines, scientific publications, and best practice recommendations was performed to design the content of the patient care booklet. Second, an Android mobile application was developed using Flutter as the cross-platform development framework, Firebase for backend services and data management, and SQLite for local data storage. Finally, a prospective pilot interventional study involving 17 patients treated with acenocoumarol was conducted to assess the usability, understanding, and satisfaction associated with both educational tools using a standardized evaluation questionnaire. Results: The developed tools provide comprehensive information on acenocoumarol therapy, including dosage instructions, drug and food interactions, INR monitoring, warning signs, and appropriate actions in case of missed doses or adverse events. The mobile application also incorporates medication reminders and interactive educational features designed to improve treatment adherence. Evaluation among the 17 participants (mean age: 67.5 years) demonstrated improved understanding of medication timing (76.5%), warning signs (64.7%), and dietary precautions (47.1%). More than half of the patients (52.9%) used the care booklet, while 64.7% installed the Android application. All application users found the medication reminders useful and the educational content clear. Overall satisfaction reached 88.2%, and all participants stated that they would recommend these tools to other patients. Conclusion: The patient care booklet and Android application developed in this study represent innovative therapeutic education tools tailored to the needs of patients receiving acenocoumarol. Their high level of acceptance and positive impact on patients' understanding suggest that they may enhance patient autonomy, improve treatment adherence, and contribute to safer anticoagulant management. Larger multicenter studies are warranted to confirm these findings and assess their impact on clinical outcomes, including INR control and the prevention of anticoagulant-related complications.