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]
The definitive published version is available online at: http://www3.interscience.wiley.com/
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 Type:||Refereed Article|
|Keywords:||continuity of patient care, patient discharge, qualitative research, warfarin|
|Research Division:||Biomedical and Clinical Sciences|
|Research Group:||Pharmacology and pharmaceutical sciences|
|Research Field:||Clinical pharmacy and pharmacy practice|
|Objective Group:||Evaluation of health and support services|
|Objective Field:||Health education and promotion|
|UTAS Author:||Stafford, L (Dr Leanne Chalmers)|
|UTAS Author:||Van Tienen, EC (Mrs Ella van Tienen)|
|UTAS Author:||Peterson, GM (Professor Gregory Peterson)|
|UTAS Author:||Bereznicki, LRE (Professor Luke Bereznicki)|
|UTAS Author:||Jackson, SL (Dr Shane Jackson)|
|Web of Science® Times Cited:||4|
|Downloads:||1 View Download Statistics|
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