Prescribers' perceptions of benefits and limitations of direct acting oral anticoagulants in non-valvular atrial fibrillation
| Autor: | Daria Generalova, Stephen J Leslie, Derek Stewart, Laura McIver, Gordon F. Rushworth, Scott Cunningham |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Health Knowledge Attitudes Practice mesh:Attitude of Health Personnel Cross-sectional study Attitude of Health Personnel media_common.quotation_subject health knowledge attitudes practice Non valvular atrial fibrillation Pharmacist Pharmaceutical Science factor xa inhibitors cross-sectional studies lcsh:RS1-441 scotland Pharmacy 030226 pharmacology & pharmacy Drug Prescriptions lcsh:Pharmacy and materia medica 03 medical and health sciences 0302 clinical medicine Perception Atrial Fibrillation medicine mesh:Drug Prescriptions atrial fibrillation Intensive care medicine Adverse effect media_common Original Research business.industry lcsh:RM1-950 mesh:Health Knowledge Attitudes Practice mesh:Factor Xa Inhibitors drug prescriptions lcsh:Therapeutics. Pharmacology Cross-Sectional Studies Summative assessment Scotland mesh:Cross-Sectional Studies Rural area business Direct acting mesh:Atrial Fibrillation attitude of health personnel mesh:Scotland Factor Xa Inhibitors |
| Zdroj: | Pharmacy Practice (Granada) v.18 n.2 2020 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname Pharmacy Practice Pharmacy Practice, Vol 18, Iss 2, p 1936 (2020) SciELO España: Revistas Científicas Españolas de Ciencias de la Salud Instituto de Salud Carlos III (ISCIII) |
| Popis: | Background: There is an acknowledged lack of robust and rigorous research focusing on the perspectives of those prescribing direct acting oral anticoagulants (DOACs) for non-valvular atrial fibrillation (AF). Objective: The objective was to describe prescribers’ experiences of using DOACs in the management of non-valvular AF, including perceptions of benefits and limitations. Methods: A cross-sectional survey of prescribers in a remote and rural area of Scotland. Among other items, the questionnaire invited free-text description of positive and negative experiences of DOACs, and benefits and limitations. Responses were independently analysed by two researchers using a summative content analysis approach. This involved counting and comparison, via keywords and content, followed by interpretation and coding of the underlying context into themes. Results: One hundred and fifty-four responses were received, 120 (77.9%) from physicians, 18 (11.7%) from nurse prescribers and 10 (6.4%) from pharmacist prescribers (6 unidentified professions). Not having to monitor INR was the most cited benefit, particularly for prescribers and patients in remote and rural settings, followed by potentially improved patient adherence. These benefits were reflected in respondents’ descriptions of positive experiences and patient feedback. The main limitations were the lack of reversal agents, cost and inability to monitor anticoagulation status. Many described their experiences of adverse effects of DOACs including fatal and non-fatal bleeding, and upper gastrointestinal disturbances. Conclusions: While prescribers have positive experiences and perceive benefits of DOACs, issues such as adverse effects and inability to monitor anticoagulation status merit further monitoring and investigation. These issues are particularly relevant given the trajectory of increased prescribing of DOACs. |
| Databáze: | OpenAIRE |
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