Periprocedural Antithrombotic Management from a Patient Perspective: A Qualitative Analysis.


Journal

The American journal of medicine
ISSN: 1555-7162
Titre abrégé: Am J Med
Pays: United States
ID NLM: 0267200

Informations de publication

Date de publication:
04 2019
Historique:
received: 06 11 2018
revised: 13 11 2018
accepted: 14 11 2018
pubmed: 7 12 2018
medline: 28 12 2019
entrez: 7 12 2018
Statut: ppublish

Résumé

Periprocedural antithrombotic medication management is a complex, often confusing process for patients and their providers. Communication difficulties often lead to suboptimal medication management, resulting in delayed or canceled procedures. We conducted telephone surveys with patients taking chronic antithrombotic medications who had recently undergone an endoscopy procedure. In the survey, we sought to better understand the periprocedural process for patients taking antithrombotic medications. We conducted a content analysis of patients' unstructured responses from the periprocedural patient phone calls. We used a multistep group coding process to analyze responses. Relationships between different themes and categories were analyzed using original quotes and retrieving thematic segments from the transcripts. The survey was administered to 81 patients; 74/81 respondents (91%) said they understood the plan to manage their antithrombotics, but 21/81 respondents (26%) were not completely satisfied with the coordination, communication, and management of their medications. Five primary themes emerged from the content analysis as patient-centered design features affecting periprocedural care: (1) patients require accurate and timely information; (2) a patient's prior experience with antithrombotic therapy affects their understanding of the process; (3) patients prefer receiving their information from a single source, and (4) also prefer different methods of instruction; (5) finally, patients expect their clinician(s) to be available through the periprocedural management process. To optimize the periprocedural medication management communication process, patients desire timeliness, accuracy, and adaptiveness to prior patient experience while offering a single, consistently available point of contact.

Sections du résumé

BACKGROUND
Periprocedural antithrombotic medication management is a complex, often confusing process for patients and their providers. Communication difficulties often lead to suboptimal medication management, resulting in delayed or canceled procedures.
METHODS
We conducted telephone surveys with patients taking chronic antithrombotic medications who had recently undergone an endoscopy procedure. In the survey, we sought to better understand the periprocedural process for patients taking antithrombotic medications. We conducted a content analysis of patients' unstructured responses from the periprocedural patient phone calls. We used a multistep group coding process to analyze responses. Relationships between different themes and categories were analyzed using original quotes and retrieving thematic segments from the transcripts.
RESULTS
The survey was administered to 81 patients; 74/81 respondents (91%) said they understood the plan to manage their antithrombotics, but 21/81 respondents (26%) were not completely satisfied with the coordination, communication, and management of their medications. Five primary themes emerged from the content analysis as patient-centered design features affecting periprocedural care: (1) patients require accurate and timely information; (2) a patient's prior experience with antithrombotic therapy affects their understanding of the process; (3) patients prefer receiving their information from a single source, and (4) also prefer different methods of instruction; (5) finally, patients expect their clinician(s) to be available through the periprocedural management process.
CONCLUSION
To optimize the periprocedural medication management communication process, patients desire timeliness, accuracy, and adaptiveness to prior patient experience while offering a single, consistently available point of contact.

Identifiants

pubmed: 30521795
pii: S0002-9343(18)31145-8
doi: 10.1016/j.amjmed.2018.11.020
pmc: PMC6445720
mid: NIHMS1515599
pii:
doi:

Substances chimiques

Fibrinolytic Agents 0

Types de publication

Journal Article Research Support, N.I.H., Extramural

Langues

eng

Sous-ensembles de citation

IM

Pagination

525-529

Subventions

Organisme : NHLBI NIH HHS
ID : K01 HL135392
Pays : United States

Informations de copyright

Copyright © 2018 Elsevier Inc. All rights reserved.

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Auteurs

Jennifer Acosta (J)

Center for Bioethics and Social Science in Medicine.

Christopher Graves (C)

Frankel Cardiovascular Center.

Elizabeth Spranger (E)

Performance Improvement, Department of Internal Medicine.

Jacob Kurlander (J)

Division of Gastroenterology, Department of Internal Medicine, University of Michigan, Ann Arbor; Veterans Affairs Ann Arbor Health Care System, Mich.

Anne E Sales (AE)

Center for Clinical Management Research, VA Ann Arbor Healthcare System; Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor.

Geoffrey D Barnes (GD)

Center for Bioethics and Social Science in Medicine; Frankel Cardiovascular Center. Electronic address: gbarnes@umich.edu.

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