Perceived advantages and disadvantages of oral anticoagulants, and the trade-offs patients make in choosing anticoagulant therapy and adhering to their drug regimen

Melissa C.W. Vaanholt, Marieke G.M. Weernink, Clemens von Birgelen, Catharina G.M. Groothuis-Oudshoorn, Maarten J. IJzerman, Janine A. van Til* (Corresponding Author)

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

10 Citations (Scopus)
111 Downloads (Pure)

Abstract

Objective: The objective of this study was to explore the perceived advantages and disadvantages of oral anticoagulant therapies (OAT), and the trade-offs patients make in choosing therapy and adhering to their drug regimen.

Methods: Five focus group sessions were conducted across Europe among patients with atrial fibrillation to identify the most important factors impacting OAT's value and adherence.

Results: The most frequently identified barriers to OAT were lack of knowledge; poor patient-physician relationships; distraction due to employment or social environment; prior bleeding event(s) or the fear of bleeding; and changes in routine. Factors identified as promoting adherence included patients' personality, motivation, attitudes, and medication-taking habits and routines, as well as good quality health services. Inconvenient aspects of vitamin-K antagonists, such as regular blood monitoring and diet restrictions, were not reported to influence adherence, but may trigger patients to switch to direct oral anticoagulants.

Conclusion: Most patients reported that a mixture of modifiable and non-modifiable factors helps them to take their drugs as prescribed. Individual patients’ particular needs and preferences regarding OAT vary. Practice implications: OAT adherence can be promoted if therapies are tailored to patients’ needs and preferences. Patients should be supported to share their preferences with their clinician.

Original languageEnglish
Pages (from-to)1982-1989
Number of pages8
JournalPatient education and counseling
Volume101
Issue number11
Early online date30 Jun 2018
DOIs
Publication statusPublished - Nov 2018

Keywords

  • Adherence
  • Anticoagulation
  • Atrial fibrillation
  • Focus group
  • Patient perspective
  • Stroke
  • Values

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