TY - JOUR
T1 - Patient perspectives of nuisance bleeding and adherence to dual antiplatelet therapy
T2 - A qualitative study
AU - Pithara, Christalla
AU - Pufulete, Maria
AU - Johnson, Thomas W
AU - Redwood, Sabi
PY - 2020/10/15
Y1 - 2020/10/15
N2 - ObjectiveTo understand the experiences of patients with dual antiplatelet therapy (DAPT) and nuisance bleeding, and their perspectives of the impact of nuisance bleeding on medication adherence and information-seeking. MethodsWe conducted focus groups with patients who had undergone percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) and conservatively managed acute coronary syndrome (ACS) patients. Two focus groups were with patients at the early stages of treatment (0-3 months), and two with patients coming to the end of treatment (9-12 months). Group discussions were audio-recorded, and recordings were transcribed verbatim, anonymised, and analysed using framework analysis. FindingsNine patients taking DAPT for up to 3 months, and 12 taking DAPT between 9 and 12 months participated in the focus groups. We found that: i) participants adhered to treatment when they believed DAPT was important to health outcomes; ii) those who experienced nuisance bleeding reported symptoms to be mild and manageable; iii) participants’ and their family’s understanding of DAPT risks and benefits, and their ability to manage symptoms, influenced perspectives of and experiences with adherence. Factors influencing DAPT knowledge included access to medication counselling, engaging with information communicated during medication counselling, and access to timely, relevant, and expert information and advice after discharge from hospital.ConclusionsPositive attitudes towards adherence were facilitated by knowledge and understanding of DAPT and confidence in dealing with symptoms caused by DAPT, but hindered by lack of opportunities to access relevant, timely, and appropriate medication counselling. Education interventions should aim to support medication literacy through family-centred approaches and involve patients and families at all stages of intervention design and evaluation.
AB - ObjectiveTo understand the experiences of patients with dual antiplatelet therapy (DAPT) and nuisance bleeding, and their perspectives of the impact of nuisance bleeding on medication adherence and information-seeking. MethodsWe conducted focus groups with patients who had undergone percutaneous coronary intervention (PCI), coronary artery bypass graft (CABG) and conservatively managed acute coronary syndrome (ACS) patients. Two focus groups were with patients at the early stages of treatment (0-3 months), and two with patients coming to the end of treatment (9-12 months). Group discussions were audio-recorded, and recordings were transcribed verbatim, anonymised, and analysed using framework analysis. FindingsNine patients taking DAPT for up to 3 months, and 12 taking DAPT between 9 and 12 months participated in the focus groups. We found that: i) participants adhered to treatment when they believed DAPT was important to health outcomes; ii) those who experienced nuisance bleeding reported symptoms to be mild and manageable; iii) participants’ and their family’s understanding of DAPT risks and benefits, and their ability to manage symptoms, influenced perspectives of and experiences with adherence. Factors influencing DAPT knowledge included access to medication counselling, engaging with information communicated during medication counselling, and access to timely, relevant, and expert information and advice after discharge from hospital.ConclusionsPositive attitudes towards adherence were facilitated by knowledge and understanding of DAPT and confidence in dealing with symptoms caused by DAPT, but hindered by lack of opportunities to access relevant, timely, and appropriate medication counselling. Education interventions should aim to support medication literacy through family-centred approaches and involve patients and families at all stages of intervention design and evaluation.
KW - Dual antiplatelet therapy (DAPT)
KW - nuisance bleeding
KW - Qualitative research
KW - Focus groups
KW - Health literacy
U2 - 10.1136/openhrt-2020-001405
DO - 10.1136/openhrt-2020-001405
M3 - Article (Academic Journal)
C2 - 33060141
SN - 2053-3624
VL - 7
JO - Open Heart
JF - Open Heart
IS - 2
M1 - e001405
ER -