Balancing risk versus benefit: The elderly patient's perspective on warfarin therapy

Bajorek, BV; Ogle, SJ; Duguid, MJ; Shenfield, GM; Krass, I

Balancing risk versus benefit: The elderly patient's perspective on warfarin therapy

Bajorek, BV

Ogle, SJ Duguid, MJ Shenfield, GM Krass, I

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Publication Type:: Journal Article
Citation:: Pharmacy Practice, 2009, 7 (2), pp. 113 - 123
Issue Date:: 2009-01-01

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Field	Value	Language
dc.contributor.author	Bajorek, BV https://orcid.org/0000-0002-2532-7187	en_US
dc.contributor.author	Ogle, SJ	en_US
dc.contributor.author	Duguid, MJ	en_US
dc.contributor.author	Shenfield, GM	en_US
dc.contributor.author	Krass, I	en_US
dc.date.available	2009-05-06	en_US
dc.date.issued	2009-01-01	en_US
dc.identifier.citation	Pharmacy Practice, 2009, 7 (2), pp. 113 - 123	en_US
dc.identifier.uri	http://hdl.handle.net/10453/17002
dc.description.abstract	Warfarin theraphy is underused in the target at-risk elderly population. Clinicians perceive that older patients are reluctant to use this theraphy, however the perspective of patients or their carers has yet to be explored. Objective: To explore in-depth the perspectives of elderly patients and/ or their carers regarding the use of warfarin therapy. Method: A qualitative study, using semi-structured group interviews was undertaken. The audio-taped discussions were transcribed verbatim, then thematically analysed to identify emergent themes. Group discussions were conducted at a major Sydney teaching hospital, over a 2-month period. Individuals aged 65 years or older (and/or their carers) who were using long-term (6 months) warfarin therapy were recruited by voluntary response to study flyers. Results: 17 patients and carers (mean age 77.2 SD=7.5 years) participated in one of two focus groups. Five core themes emerged regarding warfarin therapy: inadequate knowledge and understanding about it, patients/carers variable experience of information provision, cycle of reactions to being on it, issues in its practical management, and the spectrum of experiences with it. Overall, participants were very accepting of the therapy, describing a high level of compliance, despite initial fears and anxieties, and a relative lack of knowledge. Patients felt somewhat abandoned in their management of warfarin due to the lack of ongoing support services in the community, and inadequate information provision. Conclusions: Elderly patients and their carers appear to be quite accepting of warfarin therapy, in contrast to the perceptions of health care professionals. More effort is needed, however, in terms of information provision, particularly in the form of community-based services, to assist patients in the long-term management of warfarin.	en_US
dc.relation.ispartof	Pharmacy Practice	en_US
dc.relation.isbasedon	10.4321/S1886-36552009000200008	en_US
dc.subject.classification	Pharmacology & Pharmacy	en_US
dc.title	Balancing risk versus benefit: The elderly patient's perspective on warfarin therapy	en_US
dc.type	Journal Article
utslib.citation.volume	2	en_US
utslib.citation.volume	7	en_US
utslib.for	1115 Pharmacology and Pharmaceutical Sciences	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Graduate School of Health
utslib.copyright.status	open_access
pubs.issue	2	en_US
pubs.publication-status	Published	en_US
pubs.volume	7	en_US

Abstract:

Warfarin theraphy is underused in the target at-risk elderly population. Clinicians perceive that older patients are reluctant to use this theraphy, however the perspective of patients or their carers has yet to be explored. Objective: To explore in-depth the perspectives of elderly patients and/ or their carers regarding the use of warfarin therapy. Method: A qualitative study, using semi-structured group interviews was undertaken. The audio-taped discussions were transcribed verbatim, then thematically analysed to identify emergent themes. Group discussions were conducted at a major Sydney teaching hospital, over a 2-month period. Individuals aged 65 years or older (and/or their carers) who were using long-term (6 months) warfarin therapy were recruited by voluntary response to study flyers. Results: 17 patients and carers (mean age 77.2 SD=7.5 years) participated in one of two focus groups. Five core themes emerged regarding warfarin therapy: inadequate knowledge and understanding about it, patients/carers variable experience of information provision, cycle of reactions to being on it, issues in its practical management, and the spectrum of experiences with it. Overall, participants were very accepting of the therapy, describing a high level of compliance, despite initial fears and anxieties, and a relative lack of knowledge. Patients felt somewhat abandoned in their management of warfarin due to the lack of ongoing support services in the community, and inadequate information provision. Conclusions: Elderly patients and their carers appear to be quite accepting of warfarin therapy, in contrast to the perceptions of health care professionals. More effort is needed, however, in terms of information provision, particularly in the form of community-based services, to assist patients in the long-term management of warfarin.

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http://hdl.handle.net/10453/17002