Need for Improved Nutrition Education for Warfarin Users

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Patients with heart conditions such as arterial fibrillation and deep vein thrombosis are often prescribed Warfarin, an oral anticoagulant medication that is known to come with a range of negative and life-threatening complications. The current recommendation is that Warfarin users should aim for a stable daily vitamin K intake in order to improve the safety and efficacy of treatment. However, many studies have reported that warfarin-treated patients are often advised to either limit or avoid intake of vitamin K rich foods, especially green vegetables. This is troublesome because evidence has shown that patients with low intakes of vitamin K are more likely to experience decreased stability of warfarin therapy, leading to negative health outcomes.
The Academy of Nutrition and Dietetics conducted a study with patients enrolled in the Quebec Warfarin Cohort Study. The goal of this research was to determine what recommendations patients received from their health care professionals in regards to Vitamin K intake and whether their usual intakes vary according to these recommendations.
The data collected by the Academy of Nutrition and Dietetics highlights that avoidance of vitamin K rich foods is very common among Warfarin users. These findings are important because they suggest a discrepancy between current recommendations and the dietary habits of Warfarin users.
This study also reported that vitamin K related dietary advice was most often provided by nurses (68%), while another study reported main providers of nutrition education were pharmacists (62%). This gap between the official dietary recommendations for warfarin treatment and the vitamin K recommendations reported by patients may be related to a lack of awareness of this drug’s nutrient interactions or a lack of knowledge of vitamin K content in foods.
This study suggests that there is a need for improving nutrition education in patients receiving warfarin therapy. Registered dietitians need to take an active role in the nutrition counseling of these patients, as well as raising awareness in other health care professionals. It is discrepancies like these that must be addressed by the dietitian in order to provide the best possible care as well as show the value of this profession. 

JW 


Lablanc C, Dube M, Presse N, Dumas S, Nguyen M, Rouleau-Mailloux E, Perreault S, Ferland G. Avoidance of vitamin k-rich foods is common among Warfarin users and translates into lower usual vitamin k intakes. J Acad Nutr Diet. 2016; doi: http://dx.doi.org/10.1016/j.jand.2015.12.023.

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