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Warfarin management after discharge from hospital: a qualitative analysis

Citation

Stafford, L and Van Tienen, EC and Peterson, GM and Bereznicki, LRE and Jackson, SL and Bajorek, BV and Mullan, JR and DeBoos, IM, Warfarin management after discharge from hospital: a qualitative analysis, Journal of Clinical Pharmacy and Therapeutics, 37, (4) pp. 410-414. ISSN 0269-4727 (2012) [Refereed Article]


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The definitive published version is available online at: http://www3.interscience.wiley.com/

DOI: doi:10.1111/j.1365-2710.2011.01308.x

Abstract

What is Known and Objective:  Warfarin is recognized as a high-risk medication for adverse events, and the risks are particularly heightened in the period immediately following a patient’s discharge from hospital. This qualitative study aimed to explore the experiences of Australian patients and healthcare professionals of warfarin management in the post-discharge period and identify the benefits and deficiencies of existing systems, to inform the development of a model for a new collaborative post-discharge warfarin management service.

Methods:  Healthcare professionals, professional organization representatives and patients recently discharged from hospital taking warfarin (consumers) were recruited via purposive, criterion-based sampling within two Australian states. Semi-structured telephone interviews were conducted between August and October 2008 using standard discussion guides. Data were manually analyzed to identify emergent themes using a phenomenological approach.

Results:  Forty-seven participants were involved in the telephone interviews. Three major themes emerged: (i) appropriate warfarin education is integral to effective warfarin management, (ii) problems occur in communication along the continuum of care and (iii) home-delivered services are valuable to both patients and healthcare professionals.

Discussion:  Although high-quality warfarin education and effective communication at the hospital–community interface were identified as important in post-discharge warfarin management, deficiencies were perceived within current systems. The role of home-delivered services in ensuring timely follow-up and promoting continuity of care was recognized. Previous studies exploring anticoagulation management in other settings have identified similar themes. Post-discharge management should therefore focus on providing patients with a solid foundation to minimize future problems.

What is New and Conclusion:  Addressing the three identified facets of care within a new, collaborative post-discharge warfarin management service may address the perceived deficiencies in existing systems. Improvements may result in the short- and longer-term health outcomes of patients discharged from hospital taking warfarin, including a reduction in their risk of adverse events.

Item Details

Item Type:Refereed Article
Keywords:continuity of patient care, patient discharge, qualitative research, warfarin
Research Division:Medical and Health Sciences
Research Group:Pharmacology and Pharmaceutical Sciences
Research Field:Clinical Pharmacy and Pharmacy Practice
Objective Division:Health
Objective Group:Health and Support Services
Objective Field:Health Education and Promotion
Author:Stafford, L (Dr Leanne Chalmers)
Author:Van Tienen, EC (Mrs Ella van Tienen)
Author:Peterson, GM (Professor Gregory Peterson)
Author:Bereznicki, LRE (Associate Professor Luke Bereznicki)
Author:Jackson, SL (Dr Shane Jackson)
ID Code:74347
Year Published:2012
Web of Science® Times Cited:1
Deposited By:Pharmacy
Deposited On:2011-11-23
Last Modified:2015-08-06
Downloads:1 View Download Statistics

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