Technology-assisted self-testing and management of oral anticoagulation therapy: a qualitative patient-focused study.
Background Oral anticoagulation therapy requires regular blood testing to ensure therapeutic levels are maintained and excessive bleeding/clotting is avoided. Technology-assisted self-testing and management is seen as one of the key areas in which quality of care can be improved whilst reducing cost...
| Published in: | Scandinavian Journal of Caring Sciences Vol. 31; no. 3; pp. 603 - 618 |
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| Main Authors: | , , , , |
| Format: | pictorial research tables/charts Journal Article |
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Wiley-Blackwell
Sep2017
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=125541951&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 125541951 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 02839318 BD4 jtl: Scandinavian Journal of Caring Sciences issn: 02839318 maglogo: Y pubinfo: dt: Sep2017 vid: 31 iid: 3 pid: 480 pub: Wiley-Blackwell place: Malden, Massachusetts artinfo: ui: 125541951 125541951 125541951 10.1111/scs.12374 125541951 ppf: 603 ppct: 15 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Technology-assisted self-testing and management of oral anticoagulation therapy: a qualitative patient-focused study. aug: au: Kuljis, Jasna Money, Arthur G. Perry, Mark Barnett, Julie Young, Terry affil: Department of Computer Science, Brunel University, London UK sug: subj: Anticoagulants Administration and Dosage Home Diagnostic Tests Equipment and Supplies Self Care Venous Thrombosis Drug Therapy Pulmonary Embolism Drug Therapy Thrombosis Prevention and Control International Normalized Ratio Human Qualitative Studies Funding Source Semi-Structured Interview Cost Benefit Analysis Thematic Analysis Coding Motivation Convenience Sample Male Female Middle Age Aged Data Analysis Software Telephone Trust Middle Aged: 45-64 years Aged: 65+ years Male Female ab: Background Oral anticoagulation therapy requires regular blood testing to ensure therapeutic levels are maintained and excessive bleeding/clotting is avoided. Technology-assisted self-testing and management is seen as one of the key areas in which quality of care can be improved whilst reducing costs. Nevertheless, levels of patient engagement in self-testing and management remain low. To date, little research emphasis has been placed on understanding the patients' perspectives for low engagement. The typical approach adopted by healthcare providers is to provide patient education programmes, with the expectation that individual patients will change their behaviour and adopt new self-care strategies. However, if levels of patient engagement are to be increased, healthcare providers must also develop a better understanding of how their clinical service provision is perceived by patients and make adaptations. Objective To explore patient views, needs and expectations of an anticoagulation service and the self-testing and management services provided. Methods Interviews were conducted with 17 patients who currently engage in international normalised ratio ( INR) self-testing and management. Thematic coding and analysis were carried out on the interview transcripts. Results Four high-level themes emerged from interviews: (i) role of clinic, (ii) motivations for self-testing, (iii) managing INR and (iv) trust. The clinic was seen as adding value in terms of specifying testing frequency, dosage profiles and calibrating equipment. Prompt communication from clinic to patient was also valued, although more personalised/real-time communication would help avoid feelings of isolation. Patients felt more in control as self-tester/managers and often took decisions about treatment adjustments themselves. However, some also manipulated their own test results to avoid 'unnecessary' interventions. Conclusions and recommendations More personalised/real-time communication, pragmatic and collaborative patient-clinician partnerships and recognition of expert patient knowledge and expertise are needed if increased levels of engagement with self-testing and management service provision is to be realised. pubtype: Academic Journal doctype: pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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