Impact of Psychological Distress on Clinical and Patients? Reported Outcomes and its Associated Drug-Related Problems among Warfarin Patients

. Psychological distress often factors into severe undesirable feelings and results in prolonged negative outcomes among patients with chronic cardiac diseases particularly when they are on warfarin. The main objective of the current study was to assess psychological distress among warfarin patients and its association to various clinical and patients' reported outcomes and drug-related problems. A cross-sectional study using Perceived Stress Scale 10 (PSS 10) was performed among patients taking warfarin. Numerous clinical, sociodemographic and patients report-ed clinical data were collected. Univariate and multivariate analyses were performed to determine various factors affecting patients' diseases state regarding psychological distress, clinical and patients' reported outcomes and ob-served drug-related problems among warfarin patients diagnosed with various cardiac diseases. Descriptive and in-ferential statistics were applied using the Statistical Package for Social Sciences (SPSS) version 24.0. A p-value < 0.05 was considered statistically significant. There were more female patients (n = 238, 65.9%) than the male patients (n = 123, 34.1%) in total of 361 studied patients. The mean psychological distress of 14.00 +/- 6.87 was reported among the current studied cohort of warfarin patients. Multiple logistic regression revealed that a statistically significant differ-ence (p < 0.05) was present in the age variable among the studied warfarin patients. The present study evaluated that age was a pure contributor of severe psychological distress among warfarin patients. Major drug-related problems observed were drug choice, high dose, low dose, drug usage, contraindications and miscellaneous types. Healthcare professionals can play a vital role in decreasing psychological distress among cardiac patients on warfarin.