ArticlePloS one2021
Barriers and facilitators for optimizing oral anticoagulant management: Perspectives of patients, caregivers, and providers.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers.
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Who cites it
15 citing papers in PubMed.
- Coordination of oral anticoagulant care at hospital discharge (COACHeD): pilot randomised controlled trial.BMJ open · 2024Trial
- Patient Preferences in Anticoagulation Treatment: A Review of Discrete Choice Experiments.The patient · 2026Review
- Exploring Italian nursing staff in anticoagulation clinics: a cluster-based description of current practice, nurse self-efficacy, job satisfaction, and interprofessional collaboration.Internal and emergency medicine · 2026Article
- Drugs Don't Work in Patients Who Don't Take Them.JACC. Asia · 2026Article
- Real-World Treatment Patterns and Burden of Chronic Thromboembolic Pulmonary Hypertension Patients across Consultation Settings in the USA.Pulmonary therapy · 2026Article
- Overview of direct oral anticoagulation trends in the Bronx: case control study of patient and systemic factors in medication non-adherence.Open heart · 2026Article
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- Exploring the knowledge level and practices of hospital pharmacists in management of oral anticoagulants in Gulf Cooperation Council countries: a scoping review of literature.Frontiers in public health · 2026Article
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- Bridging the post-discharge management gap in venous thromboembolism: linking adherence patterns to persistent hypercoagulability.Frontiers in cardiovascular medicine · 2026Article
- Warfarin Adherence and Its Associated Factors in Thai Older Adults with Atrial Fibrillation.Journal of multidisciplinary healthcare · 2024Article
- Suboptimal Use of DOACs Post-Discharge for Geriatric Hip Fractures with Isolated Calf Deep Vein Thrombosis: Do Clinician Prescribing Preferences and Patient Compliance Alters Clinical Outcomes?Clinical interventions in aging · 2023Article
- Use of direct oral anticoagulants in primary care: a qualitative study integrating patient and practitioner perspectives.BJGP open · 2022Article
- Coordination of Oral Anticoagulant Care at Hospital Discharge (COACHeD): protocol for a pilot randomised controlled trial.Pilot and feasibility studies · 2022Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundOral anticoagulants (OACs) are very commonly prescribed for prevention of serious vascular events, but are also associated with serious medication-related bleeding. Mitigation of harm is believed to require high-quality OAC management. This study aimed to identify barriers and facilitators for optimal OAC management from the perspective of patients, caregivers and healthcare providers.
methodsUsing a qualitative descriptive study design, we conducted five focus groups, three with patients and caregivers and two with health care providers, in two health regions in Southwestern Ontario. An expert facilitator led the discussions using a semi-structured interview guide. Each session was digitally recorded, transcribed verbatim and anonymized. Transcripts were analyzed in duplicate using conventional content analysis.
resultsForty-two (19 patients, 7 caregivers, and 16 providers including physicians, nurses and pharmacists) participated. More than half of the patients received OAC for the treatment of venous thromboembolism (57.9%) and the majority (94.7%) were on chronic therapy (defined as >3 years). Data analysis organized codes describing barriers and facilitators into 4 main themes-medication-related, patient-related, provider-related, and system-related. Barriers highlighted were problems with medication access due to cost, patient difficulties with adherence, knowledge and adjusting their lifestyles to OAC therapy, provider expertise, time for adequate communication amongst providers and their patients, and health care system inadequacies in supporting communications and monitoring. Facilitators identified generally addressed these barriers.
conclusionsMany barriers to optimal OAC management exist even in the era of DOACs, many of which are amenable to facilitators of improved care coordination, patient education, and adherence monitoring.
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