OBJECTIVE: To examine older patients' preferences regarding the use of warfarin to prevent atrial fibrillation related strokes when faced with cumulative probabilities of treatment risk and benefit. DESIGN: A semi-qualitative researcher administered questionnaire and interview. SUBJECTS: 81 patients attending a general elderly medicine outpatient clinic. RESULTS: Up to 50% of participants would decline warfarin treatment when shown both cumulative benefits of stroke risk reduction and risk of intracerebral haemorrhage. Principal themes highlighted concepts of gambling and trade offs relating to risk and benefit. Attitudes about stroke and negative perceptions of intracerebral haemorrhage were major contributory themes in the decision to refuse warfarin treatment. CONCLUSION: Older people use very individualistic health beliefs in judging how to trade risks to preserve quality of life. Carefully explaining risk information and listening to elders' views and reasoning is likely to result in a more informed choice regarding the use of anticoagulation in stroke prevention.
OBJECTIVE: To examine older patients' preferences regarding the use of warfarin to prevent atrial fibrillation related strokes when faced with cumulative probabilities of treatment risk and benefit. DESIGN: A semi-qualitative researcher administered questionnaire and interview. SUBJECTS: 81 patients attending a general elderly medicine outpatient clinic. RESULTS: Up to 50% of participants would decline warfarin treatment when shown both cumulative benefits of stroke risk reduction and risk of intracerebral haemorrhage. Principal themes highlighted concepts of gambling and trade offs relating to risk and benefit. Attitudes about stroke and negative perceptions of intracerebral haemorrhage were major contributory themes in the decision to refuse warfarin treatment. CONCLUSION: Older people use very individualistic health beliefs in judging how to trade risks to preserve quality of life. Carefully explaining risk information and listening to elders' views and reasoning is likely to result in a more informed choice regarding the use of anticoagulation in stroke prevention.
Authors: Pablo Alonso-Coello; Victor M Montori; M Gloria Díaz; Philip J Devereaux; Gemma Mas; Ana I Diez; Ivan Solà; Mercè Roura; Juan C Souto; Sven Oliver; Rafael Ruiz; Blanca Coll-Vinent; Ignasi Gich; Holger J Schünemann; Gordon Guyatt Journal: Health Expect Date: 2014-05-12 Impact factor: 3.377
Authors: Danielle E Smith; Christian Borg Xuereb; Helen M Pattison; Gregory Y H Lip; Deirdre A Lane Journal: BMC Cardiovasc Disord Date: 2010-05-20 Impact factor: 2.298