A qualitative study exploring patient experiences and opinions of warfarin patient self‐management in the US healthcare system

• DOI: 10.1002/jac5.1912
• Publication Date: 2023-12-19T08:30:04Z
• Authors: Aaron S. Wilson; Stacey Slager; Aubrey E. Jones; Sara R. Vazquez; Geoffrey D. Barnes; Katelyn Sylvester; Linh Chan; Bishoy Ragheb; Daniel M. Witt
• Keywords: Facilitator; Implementation research

Abstract Background Despite consensus guideline recommendations, the use of warfarin patient self‐management (PSM) in United States (US) healthcare system remains underutilized. Objectives To gain an understanding barriers and facilitators to PSM US systems through qualitative exploration opinions select patients receiving therapy. Methods Individual interviews were conducted at five geographically diverse sites. Grounded theory analysis was performed on interview transcriptions using consolidated framework for implementation research (CFIR) identify within system. Results A total 40 interviewed. Four major themes emerged from interviews: (1) “Patients are resourceful problem solvers who know themselves better than clinicians” (CFIR domain “Characteristics Individuals”); (2) The provider‐patient relationship is key successful domains “Inner Setting” “Intervention Characteristics”); (3) Patients willing interested trying if not already doing so “Process,” Characteristics,” Setting, (4) Point‐of‐care international normalized ratio (INR) monitoring important facilitator “Outer Setting,” “Process” domains). Conclusions Interview participants PSM. Core elements include timely access INR results, a support decision making. Home likely ideal facilitating as maintaining strong relationships where providers, including clinical pharmacists, trust their act safety net