NUR 01.5 - eKITE: A Useful Readily Available Resource For Thrombosis And Anticoagulant Therapy

Background: Long-term anticoagulation (> 6 months) (LTA) is a chronic condition. Children and families struggle with knowledge and motivation to maintain safe therapy, including routine monitoring. The foundation of effective LTA is developing and maintaining patient knowledge about treatment. Home INR testing using a coagulometer eases the burden of regular monitoring.

Aims: To evaluate the effectiveness of eKITE to reinforce and build anticoagulation knowledge for children on LTA and their families as part of routine clinical follow-up at two children’s hospitals with dedicated anticoagulation programs.

Methods: This prospective study used the KidClot eKITE (www.kidclot.com) Warfarin series (thrombosis, safety of anticoagulation, lab INR and home INR testing) as a yearly requirement for LTA with warfarin therapy in their ongoing clinical care to refresh and build knowledge and to educate those who are transitioning to warfarin self-management. Patients performed INR testing at home using a coagulometer. Children and their families accessed the warfarin online education from home. Participants completed eKITE modules, quizzes, and surveys to assess and reinforce their warfarin knowledge. The PAC-QL tool was used to determine warfarin-related quality of life (HrQOL). INRs were collected, and time-in-range was calculated.

Results: During the study period, 159 children on LTA enrolled. 125 children performed INR tests at home, reported INRs by telephone (self-testing), and 24 transitioned to self-management. Most indications for LTA were cardiac with varied INR ranges. Yearly mean follow-up knowledge scores were 86% and 100% for warfarin self-testing and PSM, respectively. Time-in-range was 84 (IQR 73-98%) and 70.1% for self-testing and new self-management, respectively. PAC-QL scores were 29.37 (SD 12.4), increased from (21.22, SD 9.6) (P = 0.002) over health provider teaching.

Conclusion(s): eKITE is a practical, cost-effective, readily available, diverse online education to teach and provide always-available resources to children and families about thrombosis and anticoagulation, supporting knowledge of LTA and improving HrQOL.