Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2019 Apr;132(4):525-529.
doi: 10.1016/j.amjmed.2018.11.020. Epub 2018 Dec 3.

Periprocedural Antithrombotic Management from a Patient Perspective: A Qualitative Analysis

Jennifer Acosta  1 , Christopher Graves  2 , Elizabeth Spranger  3 , Jacob Kurlander  4 , Anne E Sales  5 , Geoffrey D Barnes  6
Affiliations

Periprocedural Antithrombotic Management from a Patient Perspective: A Qualitative Analysis

Jennifer Acosta et al. Am J Med. 2019 Apr.

Abstract

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.

Keywords: Anticoagulation; Antithrombotics; Patient–provider communication; Perioperative.

PubMed Disclaimer

Figures

Figure 1–
Figure 1–
Patient-centered Peri-procedural Communication Themes
Figure 2:
Figure 2:
Which provider gave you instructions on how to take your blood thinner?
See this image and copyright information in PMC

References

    1. Patak L, Wilson-Stronks A, Costello J et al. Improving Patient-Provider Communication. JONA: The Journal of Nursing Administration 2009;39(9):372–376. doi: 10.1097/nna.0b013e3181b414ca - DOI - PMC - PubMed
    1. Peimani M, Nasli-Esfahani E, Sadeghi R. Patients’ perceptions of patient–provider communication and diabetes care: A systematic review of quantitative and qualitative studies. Chronic Illn 2018:174239531878237. doi: 10.1177/1742395318782378 - DOI - PubMed
    1. Schillinger D, Machtinger E, Wang F, Palacios J, Rodriguez M, Bindman A. Language, Literacy, and Communication Regarding Medication in an Anticoagulation Clinic: A Comparison of Verbal vs. Visual Assessment. J Health Commun 2006;11(7):651–664. doi: 10.1080/10810730600934500 - DOI - PubMed
    1. Barnes G, Mouland E. Peri-Procedural Management of Oral Anticoagulants in the DOAC Era. Prog Cardiovasc Dis 2018;60(6):600–606. doi: 10.1016/j.pcad.2018.03.002 - DOI - PMC - PubMed
    1. lark N, Witt D, Davies L, Saito E, McCool K, Douketis J, Metz K and Delate T (2015). Bleeding, Recurrent Venous Thromboembolism, and Mortality Risks During Warfarin Interruption for Invasive Procedures. JAMA Internal Medicine, 175(7), p.1163. - PubMed

Publication types

MeSH terms

Substances