Periprocedural Antithrombotic Management from a Patient Perspective: A Qualitative Analysis.
Anticoagulation
Antithrombotics
Patient–provider communication
Perioperative
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
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
525-529Subventions
Organisme : NHLBI NIH HHS
ID : K01 HL135392
Pays : United States
Informations de copyright
Copyright © 2018 Elsevier Inc. All rights reserved.
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