Warfarin management after discharge from hospital: A qualitative analysis

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dc.contributor.author Stafford, L
dc.contributor.author Van Tienen, EC
dc.contributor.author Peterson, GM
dc.contributor.author Bereznicki, LRE
dc.contributor.author Jackson, SL
dc.contributor.author Bajorek, BV
dc.contributor.author Mullan, JR
dc.contributor.author DeBoos, IM
dc.date.accessioned 2012-10-12T03:34:30Z
dc.date.issued 2012-08
dc.identifier.citation Journal of Clinical Pharmacy and Therapeutics, 2012, 37 (4), pp. 410 - 414
dc.identifier.issn 0269-4727
dc.identifier.other C1UNSUBMIT en_US
dc.identifier.uri http://hdl.handle.net/10453/18666
dc.description.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. © 2011 Blackwell Publishing Ltd.
dc.language eng
dc.relation.isbasedon 10.1111/j.1365-2710.2011.01308.x
dc.title Warfarin management after discharge from hospital: A qualitative analysis
dc.type Journal Article
dc.description.version Published
dc.description.version Published
dc.parent Journal of Clinical Pharmacy and Therapeutics
dc.journal.volume 4
dc.journal.volume 37
dc.journal.number en_US
dc.publocation Oxford en_US
dc.identifier.startpage 1 en_US
dc.identifier.endpage 5 en_US
dc.cauo.name GSH.Pharmacy en_US
dc.conference Verified OK en_US
dc.for 1115 Pharmacology and Pharmaceutical Sciences
dc.personcode 112624
dc.percentage 100 en_US
dc.classification.name Pharmacology and Pharmaceutical Sciences en_US
dc.classification.type FOR-08 en_US
dc.edition en_US
dc.custom en_US
dc.date.activity en_US
dc.location.activity en_US
dc.description.keywords continuity of patient care, patient discharge, qualitative research, warfarin en_US
dc.description.keywords Dynamic modeling
dc.description.keywords Impact load
dc.description.keywords Magnetorheological absorber
dc.description.keywords Sliding mode control
dc.description.keywords continuity of patient care
dc.description.keywords patient discharge
dc.description.keywords qualitative research
dc.description.keywords warfarin
dc.description.keywords continuity of patient care
dc.description.keywords patient discharge
dc.description.keywords qualitative research
dc.description.keywords warfarin
dc.description.keywords continuity of patient care
dc.description.keywords patient discharge
dc.description.keywords qualitative research
dc.description.keywords warfarin
pubs.embargo.period Not known
pubs.organisational-group /University of Technology Sydney
pubs.organisational-group /University of Technology Sydney/Graduate School of Health
pubs.organisational-group /University of Technology Sydney/Strength - Health Services and Practice Research


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