Patients’ and healthcare professionals views/experiences of atrial fibrillation and oral anticoagulant therapy : a meta-synthesis

Abstract

Background: Atrial fibrillation (AF) patients are prescribed oral-anticoagulant (OAC) therapy, often warfarin, to reduce stroke risk. However, it is under-prescribed and sometimes refused by patients. We explored existing qualitative evidence about patients’ and health professionals’ experiences of OAC therapy. Method: Data from nine studies were synthesised qualitatively. Quality was appraised using the CASP tool. Findings: Three themes emerged: (1) deconstructing the medical consultation, (2) AF, OAC therapy and the patient experience and (3) challenges in OAC prescription and acceptance. Synthesis uncovered perspectives that could not be achieved through individual studies. Discussion: Physicians’ and patients’ experiences present a dichotomy of opinion on decision making, which requires further exploration and changes in practice. Outcomes of workload pressure on both health professionals and patients should be investigated. There is also a need for ongoing support and education to both patients and physicians, which is critical to achieve best practice and treatment adherence.