A meta-synthesis of qualitative studies exploring patients' and healthcare professionals views of atrial fibrillation and oral anticoagulant therapy

Christian Borg Xuereb, Rachel L. Shaw, Gregory Y.H. Lip, Deirdre A. Lane

Research output: Contribution to journalMeeting abstract

Abstract

Background Atrial Fibrillation (AF) is associated with a five-fold increase in the risk of stroke. Oral-anticoagulant therapy (OAC) is the recommended treatment for patients with AF in medium to high risk of stroke. The aim of the meta-synthesis was to systematically find and synthesise qualitative studies that explored views and experiences of patients and/or health professionals involved with atrial fibrillation and/or warfarin therapy.
Methods: A systematic search strategy was developed and carried out on several electronic databases. Furthermore additional strategies to maximise identification of studies were used such as reference chaining and citation searches. The Critical Appraisal Skills Programme (CASP) tool was used to appraise the studies. Qualitative data and authors’ conclusions were extracted and tabulated. These data were then synthesised through a processes of descriptive and interpretative thematic analysis.
Results: Ten studies were included following the systematic search, inclusion and quality criteria. Four third-order constructs emerged: (1)diagnosing AF and the communication of information, (2) deciding on OAC therapy, (3) challenges revolving around patient issues, and (4)healthcare challenges. Synthesis uncovered perspectives that could not be achieved through individual studies. Interpretative synthesis of the qualitative evidence indicates that the patient-physician relationship during the consultation plays a major role in motivating the patients, minimising barriers and enhancing warfarin acceptance. Patients and physician have opposing views on the experience of decision making, which requires further exploration and changes in practice. The findings also show that the need for support and education is critical for optimal care giving and compliance to treatment.
Comment: Outcomes of workload pressure on both health professionals and patients should be investigated. The need for on-going support and education to patients and physicians is critical to achieve best practice and treatment adherence. Qualitative research in this field highlights the need for health professionals to understand and attend better to the concerns of the patient.
LanguageEnglish
Article numberC0386
PagesS112-S113
Number of pages2
JournalThrombosis Research
Volume130
Issue numberSuppl.1
DOIs
Publication statusPublished - Oct 2012
Event22nd International Congress on Thrombosis - Nice, France
Duration: 6 Oct 20129 Oct 2012

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Anticoagulants
Atrial Fibrillation
Delivery of Health Care
Warfarin
Therapeutics
Health
Stroke
Physicians
Physician-Patient Relations
Qualitative Research
Patient Education
Critical Care
Workload
Practice Guidelines
Decision Making
Referral and Consultation
Communication
Databases
Education
Pressure

Bibliographical note

Abstracts and proceedings of the 22nd International Congress on Thrombosis. Nice, France, 6 – 9 October, 2012.

Cite this

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title = "A meta-synthesis of qualitative studies exploring patients' and healthcare professionals views of atrial fibrillation and oral anticoagulant therapy",
abstract = "Background Atrial Fibrillation (AF) is associated with a five-fold increase in the risk of stroke. Oral-anticoagulant therapy (OAC) is the recommended treatment for patients with AF in medium to high risk of stroke. The aim of the meta-synthesis was to systematically find and synthesise qualitative studies that explored views and experiences of patients and/or health professionals involved with atrial fibrillation and/or warfarin therapy.Methods: A systematic search strategy was developed and carried out on several electronic databases. Furthermore additional strategies to maximise identification of studies were used such as reference chaining and citation searches. The Critical Appraisal Skills Programme (CASP) tool was used to appraise the studies. Qualitative data and authors’ conclusions were extracted and tabulated. These data were then synthesised through a processes of descriptive and interpretative thematic analysis.Results: Ten studies were included following the systematic search, inclusion and quality criteria. Four third-order constructs emerged: (1)diagnosing AF and the communication of information, (2) deciding on OAC therapy, (3) challenges revolving around patient issues, and (4)healthcare challenges. Synthesis uncovered perspectives that could not be achieved through individual studies. Interpretative synthesis of the qualitative evidence indicates that the patient-physician relationship during the consultation plays a major role in motivating the patients, minimising barriers and enhancing warfarin acceptance. Patients and physician have opposing views on the experience of decision making, which requires further exploration and changes in practice. The findings also show that the need for support and education is critical for optimal care giving and compliance to treatment.Comment: Outcomes of workload pressure on both health professionals and patients should be investigated. The need for on-going support and education to patients and physicians is critical to achieve best practice and treatment adherence. Qualitative research in this field highlights the need for health professionals to understand and attend better to the concerns of the patient.",
author = "Xuereb, {Christian Borg} and Shaw, {Rachel L.} and Lip, {Gregory Y.H.} and Lane, {Deirdre A.}",
note = "Abstracts and proceedings of the 22nd International Congress on Thrombosis. Nice, France, 6 – 9 October, 2012.",
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A meta-synthesis of qualitative studies exploring patients' and healthcare professionals views of atrial fibrillation and oral anticoagulant therapy. / Xuereb, Christian Borg; Shaw, Rachel L.; Lip, Gregory Y.H.; Lane, Deirdre A.

In: Thrombosis Research, Vol. 130, No. Suppl.1, C0386 , 10.2012, p. S112-S113.

Research output: Contribution to journalMeeting abstract

TY - JOUR

T1 - A meta-synthesis of qualitative studies exploring patients' and healthcare professionals views of atrial fibrillation and oral anticoagulant therapy

AU - Xuereb, Christian Borg

AU - Shaw, Rachel L.

AU - Lip, Gregory Y.H.

AU - Lane, Deirdre A.

N1 - Abstracts and proceedings of the 22nd International Congress on Thrombosis. Nice, France, 6 – 9 October, 2012.

PY - 2012/10

Y1 - 2012/10

N2 - Background Atrial Fibrillation (AF) is associated with a five-fold increase in the risk of stroke. Oral-anticoagulant therapy (OAC) is the recommended treatment for patients with AF in medium to high risk of stroke. The aim of the meta-synthesis was to systematically find and synthesise qualitative studies that explored views and experiences of patients and/or health professionals involved with atrial fibrillation and/or warfarin therapy.Methods: A systematic search strategy was developed and carried out on several electronic databases. Furthermore additional strategies to maximise identification of studies were used such as reference chaining and citation searches. The Critical Appraisal Skills Programme (CASP) tool was used to appraise the studies. Qualitative data and authors’ conclusions were extracted and tabulated. These data were then synthesised through a processes of descriptive and interpretative thematic analysis.Results: Ten studies were included following the systematic search, inclusion and quality criteria. Four third-order constructs emerged: (1)diagnosing AF and the communication of information, (2) deciding on OAC therapy, (3) challenges revolving around patient issues, and (4)healthcare challenges. Synthesis uncovered perspectives that could not be achieved through individual studies. Interpretative synthesis of the qualitative evidence indicates that the patient-physician relationship during the consultation plays a major role in motivating the patients, minimising barriers and enhancing warfarin acceptance. Patients and physician have opposing views on the experience of decision making, which requires further exploration and changes in practice. The findings also show that the need for support and education is critical for optimal care giving and compliance to treatment.Comment: Outcomes of workload pressure on both health professionals and patients should be investigated. The need for on-going support and education to patients and physicians is critical to achieve best practice and treatment adherence. Qualitative research in this field highlights the need for health professionals to understand and attend better to the concerns of the patient.

AB - Background Atrial Fibrillation (AF) is associated with a five-fold increase in the risk of stroke. Oral-anticoagulant therapy (OAC) is the recommended treatment for patients with AF in medium to high risk of stroke. The aim of the meta-synthesis was to systematically find and synthesise qualitative studies that explored views and experiences of patients and/or health professionals involved with atrial fibrillation and/or warfarin therapy.Methods: A systematic search strategy was developed and carried out on several electronic databases. Furthermore additional strategies to maximise identification of studies were used such as reference chaining and citation searches. The Critical Appraisal Skills Programme (CASP) tool was used to appraise the studies. Qualitative data and authors’ conclusions were extracted and tabulated. These data were then synthesised through a processes of descriptive and interpretative thematic analysis.Results: Ten studies were included following the systematic search, inclusion and quality criteria. Four third-order constructs emerged: (1)diagnosing AF and the communication of information, (2) deciding on OAC therapy, (3) challenges revolving around patient issues, and (4)healthcare challenges. Synthesis uncovered perspectives that could not be achieved through individual studies. Interpretative synthesis of the qualitative evidence indicates that the patient-physician relationship during the consultation plays a major role in motivating the patients, minimising barriers and enhancing warfarin acceptance. Patients and physician have opposing views on the experience of decision making, which requires further exploration and changes in practice. The findings also show that the need for support and education is critical for optimal care giving and compliance to treatment.Comment: Outcomes of workload pressure on both health professionals and patients should be investigated. The need for on-going support and education to patients and physicians is critical to achieve best practice and treatment adherence. Qualitative research in this field highlights the need for health professionals to understand and attend better to the concerns of the patient.

U2 - 10.1016/j.thromres.2012.08.035

DO - 10.1016/j.thromres.2012.08.035

M3 - Meeting abstract

VL - 130

SP - S112-S113

JO - Thrombosis Research

T2 - Thrombosis Research

JF - Thrombosis Research

SN - 0049-3848

IS - Suppl.1

M1 - C0386

ER -