Rivaroxaban Risk Management: Qualitative Analysis of Portuguese Educational Materials

Aim/Objective: To analyze the rivaroxaban prescriber's guide (PG) and patient alert card (PAC), evaluating their legibility, intelligibility, and comprehension, as well as how this information is transmitted and understood by healthcare professionals and patients, in Portugal. Methods: In the first phase, the readability and intelligibility of the text of the educational materials under study were assessed using text analysis. The second phase consisted of assessing the readability, knowledge, access, comprehension, application, and access of the written and illustrated information in the documents, by carrying out individual semi-structured interviews with the main target audiences (prescribers and patients) and focus groups with pharmacists and nurses, as professionals who are also involved in patient care and education process. Software's used were ALT, Coh-Metrix-Port 2.0, and MAXQDA-24. Results: Both the PG and the PAC showed a medium level of readability and intelligibility. In terms of lexical analysis, it was found that the texts of the educational materials place special emphasis on issues related to taking the medication, as well as those related to risk management, particularly bleeding. More than half of the doctors interviewed reported not using the PG. It stands out that doctors were more aware of the existence of the PG while most pharmacists and nurses were more aware of the PAC. All professionals were unanimous about the importance of the existence of educational materials for rivaroxaban. Most of the pharmacists and nurses reported not having access to educational materials in their practice and believe that their use is an asset in their practice. Only 50% of the patients interviewed were aware of the card and, of these, the majority said they had never used the PAC. However, those who habitually carry this material with them say that they feel it has had a positive impact on their use of the medicine. Conclusion: Generally, healthcare professionals and patients considered the educational materials to be materials that are legible, and intelligible, with an appropriate design and typographic factors. What stands out is the doctors' lack of knowledge and reading of the educational material aimed at them - the PG. As for the patients' readability, only three had read the educational material aimed at them - PAC. This study was the starting point from which a pilot intervention will be developed to test new educational formats with patients