Implementing evidence based medicine in general practice: audit and qualitative study of antithrombotic treatment for atrial fibrillation

Abstract

Objective To determine the extent to which implementation of an evidence based treatment, antithrombotic treatment in atrial fibrillation, is possible in general practice. Design Audit and qualitative study of patients with atrial fibrillation and an educational intervention for patients judged eligible for antithrombotic treatment. Setting South east England.

Patients’ ideas, fears and expectations of their coronary risk: barriers for primary prevention

“…Apart from its presentation, risk perception is influenced by many factors, such as experience in the family, age, sex, locus of control, etc. [20,21]. It was rather striking that many persons had a dichotomous (risk/no-risk) rather than a continuous perception of the concept of risk.…”

Patients’ and health professionals’ views and experiences of atrial fibrillation and oral-anticoagulant therapy: A qualitative meta-synthesis

“…This knowledge often had a negative influence on warfarin acceptance. [21,23,27,28] A common patient belief mentioned in these six studies was the awareness of warfarin being used as rat poison.…”

Optimizing the use of oral anticoagulant therapy for atrial fibrilation in primary care: a pharmacist-led intervention

“…One limitation of this study is that no data were collected on reasons for refusal. However, qualitative studies provide the following explanations: patient perception of increased bleeding risk; individual patient preferences; personally held beliefs [37,38,40]; feeling unable to make a judgement; reluctance to change therapy [40]; and aversions to taking medication [41]. There is also limited evidence that shared decision making may lead to more conservative decision making [42], with some patients expressing a desire to leave the final decision to the practitioner [43].…”