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Physicians' views on patient participation in choice of oral anticoagulants in atrial fibrillation - a qualitative study

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Date
2018
Author(s)
Aarnio, Emma
Huupponen, Risto
Hämeen-Anttila, Katri
Merikoski, Merja
Puhakka, Jaana
Korhonen, Maarit J
Unique identifier
10.1111/bcpt.13145
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Citation
Aarnio, Emma. Huupponen, Risto. Hämeen-Anttila, Katri. Merikoski, Merja. Puhakka, Jaana. Korhonen, Maarit J. (2018). Physicians' views on patient participation in choice of oral anticoagulants in atrial fibrillation - a qualitative study.  BASIC & CLINICAL PHARMACOLOGY & TOXICOLOGY, [Epub ahead of print 31 Oct 2018], 10.1111/bcpt.13145.
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Abstract

Direct oral anticoagulants provide an alternative to vitamin K antagonists for the anticoagulation therapy in atrial fibrillation (AF). The availability of several treatment options with different attributes makes shared decision‐making appropriate for the choice of anticoagulation therapy. The aim of this study was to understand how physicians choose an oral anticoagulant (OAC) for patients with AF and how physicians view patients’ participation in this decision. Semi‐structured interviews with 17 Finnish physicians (eight general practitioners and nine specialists) working in the public sector were conducted. An interview guide on experience, prescribing and opinions about oral anticoagulants was developed based on previous literature. The data were thematically analysed using deductive and inductive approaches. Based on the interviews, patient's opinion was the most influential factor in decision‐making when there were no clinical factors limiting the choice between OACs. Of patient's preferences, the most important was the attitude towards co‐payments of OACs. Patients’ opinions on monitoring of treatment, dosing and antidote availability were also mentioned by the interviewees. The choice of an OAC in AF was patient‐centred as all interviewees expressed that patient's opinion affects the choice.

Subjects
atrial fibrillation   direct oral anticoagulants   interview   prescription of drugs   warfarin   
URI
https://erepo.uef.fi/handle/123456789/7330
Link to the original item
http://dx.doi.org/10.1111/bcpt.13145
Publisher
Wiley
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  • Terveystieteiden tiedekunta [1337]
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