ArticleInternational journal of clinical pharmacy2025
A qualitative evaluation of barriers and facilitators to a large-scale antithrombotic stewardship intervention in the United States Veterans Healthcare system.
Article in International journal of clinical pharmacy, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
backgroundThe combined use of antiplatelet medications with direct oral anticoagulants increases patients' risk of hemorrhage. In 2021, a multistate network of Veterans Affairs medical centers in the United States deployed a successful multicomponent stewardship initiative to reduce inappropriate anticoagulant-antiplatelet therapy.
aimIdentify barriers, facilitators, and potential adaptations of the initiative to guide broader dissemination.
methodsClinical pharmacists and pharmacist managers were invited to participate in semi-structured interviews about their experiences with the initiative. Interviews were transcribed. Thematic analysis was informed by the Consolidated Framework for Implementation Research (CFIR).
resultsFifteen interviews were completed (response rate 68%). The initiative was considered important and worth disseminating, and the addition of a visual alert to flag potential deprescribing candidates on an anticoagulation population management dashboard was considered especially beneficial. Three primary themes were identified using the CFIR. First, pharmacists often encountered barriers to coordination across specialties, with some clinicians unconvinced of the clinical evidence favoring antiplatelet deprescribing; breaking down these clinical silos, through targeted education and identifying meaningful clinician champions, is essential to increasing success of this initiative. Second, pharmacists sought clarification about how their deprescribing efforts, a relatively new activity, would be accounted for in performance evaluations, and how clinics would meet increased staffing needs. Third, adaptability of the initiative to local context was considered valuable.
conclusionAs part of a multicomponent oral anticoagulant-antiplatelet stewardship initiative, preventing clinical silos, clarifying expectations around performance and staffing, and permitting adaptations to local context are important to maximizing impact.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.