Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation

Oral anticoagulant therapy reduces the risk of stroke in patients with atrial fibrillation, but many patients are still not prescribed this therapy. The causes of underuse of vitamin K antagonists oral anticoagulants are not clear but could be related, in part, to patients' and physicians'...

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Autores: Mas Dalmau, Gemma|||0000-0003-3720-0797, Sant Arderiu, E., Enfedaque Montes, Belen|||0000-0002-2843-7250, Solà Arnau, Ivan|||0000-0003-0078-3706, Pequeño Saco, S., Alonso-Coello, Pablo|||0000-0002-8001-8504
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:289309
Acceso en línea:https://ddd.uab.cat/record/289309
https://dx.doi.org/urn:doi:10.1186/s12875-016-0574-0
Access Level:acceso abierto
Palabra clave:Atrial fibrillation
Attitudes
Oral-anticoagulation theraopy
Patients
Perceptions
Physicians
Qualitative Research
Systematic Review
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spelling Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillationa qualitative systematic reviewMas Dalmau, Gemma|||0000-0003-3720-0797Sant Arderiu, E.Enfedaque Montes, Belen|||0000-0002-2843-7250Solà Arnau, Ivan|||0000-0003-0078-3706Pequeño Saco, S.Alonso-Coello, Pablo|||0000-0002-8001-8504Atrial fibrillationAttitudesOral-anticoagulation theraopyPatientsPerceptionsPhysiciansQualitative ResearchSystematic ReviewOral anticoagulant therapy reduces the risk of stroke in patients with atrial fibrillation, but many patients are still not prescribed this therapy. The causes of underuse of vitamin K antagonists oral anticoagulants are not clear but could be related, in part, to patients' and physicians' perceptions and attitudes towards the benefits and downsides of this treatment. The purpose of this systematic review was to evaluate and synthesize patients' and physicians' perceptions and attitudes towards the benefits and downsides of vitamin K antagonist, in order to explore potential factors related with its underuse. We included studies that used qualitative or mixed methods and focused on patients' and/or physicians' perceptions and attitudes towards oral anticoagulation. We systematically searched PubMed, EMBASE, ISI WoK, and PsycINFO from their inception until May 2013. Two reviewers independently assessed the quality of the included studies and synthesized results using a thematic analysis approach. We included a total of nine studies. In four studies, the quality assessed was excellent and in five was moderate. We identified three themes that were of interest to both physicians and patients: information to reinforce anticoagulation use, balance of benefits and downsides, roles in decision-making and therapy management. Three additional themes were of interest to patients: knowledge and understanding, impact on daily life, and satisfaction with therapy. The main difficulties with the use of anticoagulant treatment according to physicians were the perceived uncertainty, need of individualised decision-making, and the feeling of delegated responsibility as their main concerns. The main factors for patients were the lack of information and understanding. Physicians' and patients' perceptions and attitudes might be potential factors in the underuse of treatment with vitamin K antagonists. Improving the quality and usability of clinical guidelines, developing tools to help with the decision-making, enhancing coordination between primary care and hospital care, and improving information provided to patients could help improve the underuse of anticoagulation.Universitat Autònoma de Barcelona 22017-01-0120172017-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/289309https://dx.doi.org/urn:doi:10.1186/s12875-016-0574-0reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengMinisterio de Sanidad y Consumo PI06/90391open accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2893092026-06-06T12:50:31Z
dc.title.none.fl_str_mv Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation
a qualitative systematic review
title Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation
spellingShingle Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation
Mas Dalmau, Gemma|||0000-0003-3720-0797
Atrial fibrillation
Attitudes
Oral-anticoagulation theraopy
Patients
Perceptions
Physicians
Qualitative Research
Systematic Review
title_short Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation
title_full Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation
title_fullStr Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation
title_full_unstemmed Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation
title_sort Patients' and physicians' perceptions and attitudes about oral anticoagulation and atrial fibrillation
dc.creator.none.fl_str_mv Mas Dalmau, Gemma|||0000-0003-3720-0797
Sant Arderiu, E.
Enfedaque Montes, Belen|||0000-0002-2843-7250
Solà Arnau, Ivan|||0000-0003-0078-3706
Pequeño Saco, S.
Alonso-Coello, Pablo|||0000-0002-8001-8504
author Mas Dalmau, Gemma|||0000-0003-3720-0797
author_facet Mas Dalmau, Gemma|||0000-0003-3720-0797
Sant Arderiu, E.
Enfedaque Montes, Belen|||0000-0002-2843-7250
Solà Arnau, Ivan|||0000-0003-0078-3706
Pequeño Saco, S.
Alonso-Coello, Pablo|||0000-0002-8001-8504
author_role author
author2 Sant Arderiu, E.
Enfedaque Montes, Belen|||0000-0002-2843-7250
Solà Arnau, Ivan|||0000-0003-0078-3706
Pequeño Saco, S.
Alonso-Coello, Pablo|||0000-0002-8001-8504
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Universitat Autònoma de Barcelona
dc.subject.none.fl_str_mv Atrial fibrillation
Attitudes
Oral-anticoagulation theraopy
Patients
Perceptions
Physicians
Qualitative Research
Systematic Review
topic Atrial fibrillation
Attitudes
Oral-anticoagulation theraopy
Patients
Perceptions
Physicians
Qualitative Research
Systematic Review
description Oral anticoagulant therapy reduces the risk of stroke in patients with atrial fibrillation, but many patients are still not prescribed this therapy. The causes of underuse of vitamin K antagonists oral anticoagulants are not clear but could be related, in part, to patients' and physicians' perceptions and attitudes towards the benefits and downsides of this treatment. The purpose of this systematic review was to evaluate and synthesize patients' and physicians' perceptions and attitudes towards the benefits and downsides of vitamin K antagonist, in order to explore potential factors related with its underuse. We included studies that used qualitative or mixed methods and focused on patients' and/or physicians' perceptions and attitudes towards oral anticoagulation. We systematically searched PubMed, EMBASE, ISI WoK, and PsycINFO from their inception until May 2013. Two reviewers independently assessed the quality of the included studies and synthesized results using a thematic analysis approach. We included a total of nine studies. In four studies, the quality assessed was excellent and in five was moderate. We identified three themes that were of interest to both physicians and patients: information to reinforce anticoagulation use, balance of benefits and downsides, roles in decision-making and therapy management. Three additional themes were of interest to patients: knowledge and understanding, impact on daily life, and satisfaction with therapy. The main difficulties with the use of anticoagulant treatment according to physicians were the perceived uncertainty, need of individualised decision-making, and the feeling of delegated responsibility as their main concerns. The main factors for patients were the lack of information and understanding. Physicians' and patients' perceptions and attitudes might be potential factors in the underuse of treatment with vitamin K antagonists. Improving the quality and usability of clinical guidelines, developing tools to help with the decision-making, enhancing coordination between primary care and hospital care, and improving information provided to patients could help improve the underuse of anticoagulation.
publishDate 2017
dc.date.none.fl_str_mv 2
2017-01-01
2017
2017-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/289309
https://dx.doi.org/urn:doi:10.1186/s12875-016-0574-0
url https://ddd.uab.cat/record/289309
https://dx.doi.org/urn:doi:10.1186/s12875-016-0574-0
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.relation.none.fl_str_mv Ministerio de Sanidad y Consumo PI06/90391
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
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