NDLI: Understanding the barriers to using oral anticoagulants among long-term aspirin users with atrial fibrillation

Content Provider	Springer Nature : BioMed Central
Author	Ng, Vanessa W. S. Siu, Chung-Wah Chiu, Patrick K. C. Kng, Carolyn P. L. Jamieson, Elizabeth Wong, Ian C. K. Lam, May P. S.
Abstract	Background Despite international treatment guidelines currently advocating oral anticoagulants (OACs) as the only appropriate stroke prevention therapy for patients with atrial fibrillation (AF) and evidence that OACs can greatly reduce the risk of stroke with similar risk of bleeding compared with aspirin, the underuse of OACs in patients with AF is common globally, especially in Asia. This study aimed to identify the barriers to prescribing and using OACs among long-term aspirin users with AF. Method Face-to-face interviews were conducted with fourteen eligible patients with AF using a semi-structured interview guide. The interview recordings were transcribed verbatim and data was analyzed according to the principles of thematic analysis. Results Five themes were developed: awareness of AF symptoms and diagnosis; knowledge and understanding of AF and stroke prevention therapy; role of decision-making in prescribing; willingness to switch from aspirin to OACs; and impact of OAC regimen on daily living. The majority of the patients were not aware of the symptoms and diagnosis of AF and only had a vague understanding of the illness and stroke prevention therapy, leading to their minimal involvement in decisions relating to their treatment. Some patients and their caregivers were particularly concerned about the bleeding complications from OACs and perceived aspirin to be a suitable alternative as they find the adverse effects from aspirin manageable and so preferred to remain on aspirin if switching to OACs was not compulsory. Lastly, the lifestyle modifications required when using warfarin, e.g. alternative dosing regimen, diet restriction, were seen as barriers to some patients and caregivers. Conclusion The findings revealed patients’ knowledge gap in AF management which may be targeted using educational interventions to improve patients’ understanding of AF and its management and hence encourage active participation in the decision-making of their treatment in the future.
Related Links	https://bmchealthservres.biomedcentral.com/counter/pdf/10.1186/s12913-020-05947-3.pdf
Ending Page	8
Page Count	8
Starting Page	1
File Format	HTM / HTML
ISSN	14726963
DOI	10.1186/s12913-020-05947-3
Journal	BMC Health Services Research
Issue Number	1
Volume Number	20
Language	English
Publisher	BioMed Central
Publisher Date	2020-11-25
Access Restriction	Open
Subject Keyword	Public Health Health Administration Health Informatics Nursing Research Barriers Oral anticoagulants Aspirin Atrial fibrillation
Content Type	Text
Resource Type	Article
Subject	Health Policy

Sl.	Authority	Responsibilities	Communication Details
1	Ministry of Education (GoI), Department of Higher Education	Sanctioning Authority	https://www.education.gov.in/ict-initiatives
2	Indian Institute of Technology Kharagpur	Host Institute of the Project: The host institute of the project is responsible for providing infrastructure support and hosting the project	https://www.iitkgp.ac.in
3	National Digital Library of India Office, Indian Institute of Technology Kharagpur	The administrative and infrastructural headquarters of the project	Dr. B. Sutradhar bsutra@ndl.gov.in
4	Project PI / Joint PI	Principal Investigator and Joint Principal Investigators of the project	Dr. B. Sutradhar bsutra@ndl.gov.in Prof. Saswat Chakrabarti will be added soon
5	Website/Portal (Helpdesk)	Queries regarding NDLI and its services	support@ndl.gov.in
6	Contents and Copyright Issues	Queries related to content curation and copyright issues	content@ndl.gov.in
7	National Digital Library of India Club (NDLI Club)	Queries related to NDLI Club formation, support, user awareness program, seminar/symposium, collaboration, social media, promotion, and outreach	clubsupport@ndl.gov.in
8	Digital Preservation Centre (DPC)	Assistance with digitizing and archiving copyright-free printed books	dpc@ndl.gov.in
9	IDR Setup or Support	Queries related to establishment and support of Institutional Digital Repository (IDR) and IDR workshops	idr@ndl.gov.in

Barriers and facilitators to using NHS Direct: a qualitative study of `users’ and `non-users’

Values and preferences in oral anticoagulation in patients with atrial fibrillation, physicians' and patients' perspectives: protocol for a two-phase study

Cost of illness of atrial fibrillation: a nationwide study of societal impact

Guideline-discordant dosing of direct-acting oral anticoagulants in the veterans health administration

Characteristics affecting oral anticoagulant therapy choice among patients with non-valvular atrial fibrillation: a retrospective claims analysis

Optimising clinical effectiveness and quality along the atrial fibrillation anticoagulation pathway: an economic analysis

Costs of major intracranial, gastrointestinal and other bleeding events in patients with atrial fibrillation – a nationwide cohort study

Physicians’ understanding of antibiotic intravenous-to-oral switching—a qualitative study in Suzhou, China

What are the perceived added values and barriers of regulating long-term care in the home environment using a care network perspective: a qualitative study

Understanding the barriers to using oral anticoagulants among long-term aspirin users with atrial fibrillation – a qualitative study

Similar Documents

Barriers and facilitators to using NHS Direct: a qualitative study of `users’ and `non-users’

Values and preferences in oral anticoagulation in patients with atrial fibrillation, physicians' and patients' perspectives: protocol for a two-phase study

Cost of illness of atrial fibrillation: a nationwide study of societal impact

Guideline-discordant dosing of direct-acting oral anticoagulants in the veterans health administration

Characteristics affecting oral anticoagulant therapy choice among patients with non-valvular atrial fibrillation: a retrospective claims analysis

Optimising clinical effectiveness and quality along the atrial fibrillation anticoagulation pathway: an economic analysis

Costs of major intracranial, gastrointestinal and other bleeding events in patients with atrial fibrillation – a nationwide cohort study

Physicians’ understanding of antibiotic intravenous-to-oral switching—a qualitative study in Suzhou, China

What are the perceived added values and barriers of regulating long-term care in the home environment using a care network perspective: a qualitative study

Understanding the barriers to using oral anticoagulants among long-term aspirin users with atrial fibrillation – a qualitative study