Strategies for Enhancing Anticoagulation Adherence in Adult Patients After Cardiac Valve Replacement: An Evidence-Based Summary

Yangyao Peng,1,* Jingjing Huang,2,* Shuwen Qin,1 Bangyu Guo,1 Qian Hu,1 Dandan Xu,3 Caixia Gao,1 Fen Hu1,4,5 1Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China; 2Department of Plastic Surgery, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China; 3Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China; 4Nursing Department, Zhongnan Hospital of Wuhan University, Wuhan, Hubei, 430071, People’s Republic of China; 5Center for Critical Care and Anesthesia Nursing Research, Wuhan, Hubei, 430071, People’s Republic of China*These authors contributed equally to this workCorrespondence: Caixia Gao, Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, People’s Republic of China, Email [email protected] Fen Hu, Department of Cardiovascular Surgery, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuhan, Hubei, People’s Republic of China, Email [email protected]: Heart valve replacement is one of the primary treatments for valvular heart disease. Postoperatively, patients require long-term anticoagulation therapy to prevent life-threatening thromboembolic events. However, poor patient adherence to anticoagulation can lead to complications such as thrombosis and embolism, adversely impacting patient prognosis. This study aimed to systematically search for the best available evidence on anticoagulation adherence management to provide evidence-based guidance for the clinical practice concerning adult patients after heart valve replacement.Methods: Following the “ 6S” evidence resource model, evidence retrieval was conducted in a top-down manner, collecting relevant guidelines, best practices, evidence summaries, systematic reviews, and expert consensuses. The search period was limited to databases from January 1, 2015, to May 31, 2025. Two evidence-trained researchers independently appraised the quality of the included literature. Evidence was then extracted and summarized according to the JBI evidence grading and recommendation system.Results: A total of 13 articles were finally included, comprising 5 clinical decisions, 1 evidence summary, 3 guidelines, 2 systematic reviews, 1 expert consensus, and 1 randomized controlled trial. Eighteen best evidence statements were summarized from four dimensions: symptom assessment, monitoring modalities and methods, quality control and management, and patient education.Conclusion: This study summarized the best evidence for anticoagulation adherence management after heart valve replacement across four dimensions. This can provide guidance for clinical or community healthcare professionals in developing and implementing interventions and practice programs to improve patient adherence to anticoagulation, thereby improving clinical outcomes and quality of life for patients post-heart valve replacement.Keywords: evidence summary, evidence-based nursing, medication compliance, valvular heart disease