Melissa C W Vaanholt1, Marieke G M Weernink2, Clemens von Birgelen3, Catharina G M Groothuis-Oudshoorn4, Maarten J IJzerman5, Janine A van Til6. 1. Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands. Electronic address: m.c.w.vaanholt@utwente.nl. 2. Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands. Electronic address: m.g.m.weernink@utwente.nl. 3. Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands; Thoraxcentrum Twente, Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands. Electronic address: c.vonbirgelen@mst.nl. 4. Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands. Electronic address: c.g.m.oudshoorn@utwente.nl. 5. Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands. Electronic address: m.j.ijzerman@utwente.nl. 6. Department of Health Technology and Services Research, Faculty of Behavioural, Management and Social Sciences, Technical Medical Centre, University of Twente, Enschede, The Netherlands. Electronic address: j.a.vantil@utwente.nl.
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.
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.
Authors: Marieke G M Weernink; Melissa C W Vaanholt; Catharina G M Groothuis-Oudshoorn; Clemens von Birgelen; Maarten J IJzerman; Janine A van Til Journal: Am J Cardiovasc Drugs Date: 2018-12 Impact factor: 3.571
Authors: Sonal Ghura Mansukhani; Elizabeth A MacLean; Laura L Manzey; Carl J Possidente; Joseph C Cappelleri; Linda S Deal Journal: Patient Prefer Adherence Date: 2021-09-09 Impact factor: 2.711