Warfarin
therapy is underused in the target at-risk elderly population.
Clinicians perceive that older patients are reluctant to use this
therapy, 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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