Perceptions of patients and healthcare providers on patient education to improve oral anticoagulant management

Abstract

Rationale and Objectives Education of patients is thought to be key to high‐quality oral anticoagulant (OAC) medication management. Theoretically, improving patients' knowledge should improve their self‐management skills and adherence. The study's objective was to explore the opinions of healthcare providers and patients on the desired content and format of patient education on OACs, in addition to perceived barriers to high‐quality patient education. Methods We applied qualitative descriptive methods in a focus group study on OAC management. Five focus group discussions were conducted in two health regions in Southwestern Ontario from 2017 to 2018 with 19 patients, 7 caregivers and 16 healthcare providers (physicians, nurses and pharmacists). During the focus groups, participants discussed their experiences with OAC education and made suggestions about the content and format for patient education on OACs. Transcripts were analysed using conventional content analysis. Results We identified the five themes of patient education on OAC management: content of OAC education (rationale, risk and appropriate drug administration methods), the best times for providing OAC education (time of OACs initiation along with continuing education), preferred education delivery strategies (case management targeted patient information summaries from authoritative sources such as Thrombosis Canada and video education), patient and community pharmacist engagement in OAC education, and perceived barriers to optimal patient education (patients depending too much on their healthcare providers for advice, the limited time patients spend with healthcare providers, gaps in clear communication between providers and the lack of a nationally or provincially coordinated OAC management programme). Conclusion Our findings suggest that patients, caregivers and healthcare providers support the need for education on OACs, including for patients taking DOACs. Specific important content and proper education format are needed. The optimal combination of content, format, duration, timing and sources for OAC education requires further research.

Reasons for Nonadherence to the Direct Oral Anticoagulant Apixaban

“…Patient knowledge about the existence of reversal agents, the frequency of physician communication about these agents, and the influence of knowledge about the agents on adherence requires additional exploration, as does the relationship of these interventions on patient adherence. Qualitative work suggests that patients and providers support educating patients about DOACs, 43 and indeed, patient education has successfully increased adherence to other medications, including to warfarin. 33 , 44 However, studies focused on DOAC adherence are needed.…”

Evaluation of patients' experience and related qualitative outcomes in venous thromboembolism: A scoping review

“…12,54,55 Educational programs typically focus on anticoagulation management; however, our study results suggest that this should be expanded to recognize VTE as a disease with many impacts. [56][57][58] Education and patient support are integral at all time points across a patient's VTE journey. Baddeley All authors revised and approved the final draft of the manuscript.…”

Knowledge, attitude and practice toward oral anticoagulants among patients with atrial fibrillation

“…Many studies suggested that OACs in AF patients may also reduce the risk of cognitive decline and dementia (6). However, the optimal use of OACs requires proper patient education and engagement in the management of their condition (7). AF patients need to be aware of their condition, understand the risks and benefits of OACs, and adhere to the prescribed treatment regimen to achieve the best outcomes (8).…”