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Supporting patients to self-monitor their oral anticoagulation therapy : recommendations based on a qualitative study of patients' experiences
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Tompson, A., Heneghan, C., Fitzmaurice, David, Sutton, S., Harrison, S. and Ward, A. (2015) Supporting patients to self-monitor their oral anticoagulation therapy : recommendations based on a qualitative study of patients' experiences. British Journal of General Practice, 65 (636). e438-e446. doi:10.3399/bjgp15X685645 ISSN 0960-1643.
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Official URL: http://dx.doi.org/10.3399/bjgp15X685645
Abstract
Background Clinical trials suggest that oral anticoagulation therapy (OAT) self-monitoring is safe and effective, however little is known about the patient experience of this process. There is a lack of understanding about how best to train and support patients embarking on OAT self-monitoring.
Aim To collect in-depth information about patients’ experiences of OAT self-monitoring outside of clinical trial conditions and to produce a set of recommendations on how best to support such patients.
Design and setting Semi-structured qualitative interviews with patients who self-monitor and live in England.
Method In total, 26 of the 267 (9.7%) who participated in the Cohort study of Anticoagulation Self-Monitoring (CASM) and were still self-monitoring after 12 months’ follow-up were interviewed. Topics discussed included experiences of OAT self-monitoring, healthcare support, training, and decision making. Framework analysis was used.
Results Following initial problems using the monitoring device, interviewees described a mostly positive experience. Although less effort was expended attending monitoring appointments with health professionals, effort was required to conduct self-monitoring tests and to interpret and act on the results. Desire to self-manage was variable, especially when dosing advice systems worked promptly and reliably. Interviewees overcame patchy healthcare system knowledge and support of self-monitoring by educating themselves. Family and friends provided support with learning to use the monitor and managing OAT dosage adjustments.
Conclusion Better, more-consistent training and health-service support would have alleviated a number of problems encountered by these patients who were self-monitoring. This training and support will become even more important if self-monitoring becomes more accessible to the general population of people on OAT.
Item Type: | Journal Article | ||||
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Clinical Trials Unit Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Journal or Publication Title: | British Journal of General Practice | ||||
Publisher: | Royal College of General Practitioners | ||||
ISSN: | 0960-1643 | ||||
Official Date: | August 2015 | ||||
Dates: |
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Volume: | 65 | ||||
Number: | 636 | ||||
Page Range: | e438-e446 | ||||
DOI: | 10.3399/bjgp15X685645 | ||||
Status: | Peer Reviewed | ||||
Access rights to Published version: | Restricted or Subscription Access |
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