Department of Health Research Methods, Evidence, and Impact (HEI), McMaster University, Hamilton, Ontario, Canada.
Clinical Pharmacology & Toxicology Research, The Research Institute of St. Joseph's Hamilton, Hamilton, Ontario, Canada.
J Eval Clin Pract. 2022 Dec;28(6):1027-1036. doi: 10.1111/jep.13665. Epub 2022 Feb 9.
Education of patients is thought to be key to high-quality oral anticoagulant (OAC) medication management. Theoretically, improving patients' knowledge should improve their self-management skills and adherence. The study's objective was to explore the opinions of healthcare providers and patients on the desired content and format of patient education on OACs, in addition to perceived barriers to high-quality patient education.
We applied qualitative descriptive methods in a focus group study on OAC management. Five focus group discussions were conducted in two health regions in Southwestern Ontario from 2017 to 2018 with 19 patients, 7 caregivers and 16 healthcare providers (physicians, nurses and pharmacists). During the focus groups, participants discussed their experiences with OAC education and made suggestions about the content and format for patient education on OACs. Transcripts were analysed using conventional content analysis.
We identified the five themes of patient education on OAC management: content of OAC education (rationale, risk and appropriate drug administration methods), the best times for providing OAC education (time of OACs initiation along with continuing education), preferred education delivery strategies (case management targeted patient information summaries from authoritative sources such as Thrombosis Canada and video education), patient and community pharmacist engagement in OAC education, and perceived barriers to optimal patient education (patients depending too much on their healthcare providers for advice, the limited time patients spend with healthcare providers, gaps in clear communication between providers and the lack of a nationally or provincially coordinated OAC management programme).
Our findings suggest that patients, caregivers and healthcare providers support the need for education on OACs, including for patients taking DOACs. Specific important content and proper education format are needed. The optimal combination of content, format, duration, timing and sources for OAC education requires further research.
人们认为对患者进行教育是高质量口服抗凝药物（OAC）管理的关键。理论上，提高患者的知识水平应该能够提高其自我管理技能和依从性。本研究的目的是探讨医疗保健提供者和患者对 OAC 患者教育的内容和形式的期望，以及对高质量患者教育的障碍的看法。
我们采用定性描述方法，在安大略省西南部的两个卫生区进行了一项 OAC 管理的焦点小组研究。2017 年至 2018 年，我们共进行了 5 次焦点小组讨论，参与者包括 19 名患者、7 名护理人员和 16 名医疗保健提供者（医生、护士和药剂师）。在焦点小组讨论中，参与者讨论了他们在 OAC 教育方面的经验，并对 OAC 患者教育的内容和形式提出了建议。对转录本进行了常规内容分析。
我们确定了 OAC 管理患者教育的五个主题：OAC 教育的内容（原理、风险和适当的药物管理方法）、提供 OAC 教育的最佳时间（OAC 开始时以及继续教育时）、首选的教育提供策略（病例管理针对患者的信息，这些信息来自于权威来源，如加拿大血栓形成协会和视频教育）、患者和社区药剂师参与 OAC 教育，以及对最佳患者教育的障碍的看法（患者过多地依赖医疗保健提供者的建议，患者与医疗保健提供者相处的时间有限，提供者之间的沟通不明确，缺乏国家或省级协调的 OAC 管理计划）。
我们的研究结果表明，患者、护理人员和医疗保健提供者支持对 OAC 进行教育，包括对接受 DOAC 治疗的患者进行教育。需要具体的重要内容和适当的教育形式。OAC 教育的内容、形式、时长、时间和来源的最佳组合需要进一步研究。
