Barriers to Good Therapy: Patients', Physicians', and Health Plan Providers' Perspectives of Acute Myocardial Infarction Patients' Discontinuation of Plavix

2.50
Hdl Handle:
http://hdl.handle.net/10755/159655
Type:
Presentation
Title:
Barriers to Good Therapy: Patients', Physicians', and Health Plan Providers' Perspectives of Acute Myocardial Infarction Patients' Discontinuation of Plavix
Abstract:
Barriers to Good Therapy: Patients', Physicians', and Health Plan Providers' Perspectives of Acute Myocardial Infarction Patients' Discontinuation of Plavix
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2007
Author:Decker, Carole, PhD, RN
P.I. Institution Name:Mid America Heart Institute
Contact Address:CV Research, 4401 Wornall Road, Kansas City, MO, 64111, USA
Co-Authors:B. Garavalia and J.A. Spertus, Cardiovascular Research, Mid America Heart Institute, Kansas City, MO and L. Garavalia, Department of Psychology, University of Missouri-Kansas City, Kansas City, MO
Background & Objective: An earlier quantitative study from our group indicated 14% of MI patients discontinue thienopyridines (antiplatelet therapy, Plavix) at 1 month after receiving a drug-eluting stent. Patients who discontinued Plavix early were 9 times more likely to die or have a cardiac rehospitalization within 1 year than those who continued the medication. The purpose of this study is to examine patient, clinician, and health plan provider perspectives to understand why patients discontinue Plavix prior to recommended duration, presenting patient results here. Subjects & Methods: We recently performed in-depth qualitative research with MI Registry patients who reported stopping Plavix during their 1 month follow-up visit. The ongoing TRIUMPH Registry is enrolling MI patients at 19 centers across the US and includes detailed interview and clinical elements, plus follow-up interviews at 1, 6, and 12 months following the MI. The Health Belief Model (HBM) was utilized as the framework for question development. A trained health interviewer conducted and recorded the 30 minute interview by phone. The tapes were transcribed, coded, and then analyzed by three experienced researchers. Results & Conclusions: Twelve MI patients who reported stopping Plavix at 1 month were interviewed, having reached data saturation. The main themes emerged set in the HBM were: Severity: recognition vs. non recognition, good health; Threat: accurate vs. inaccurate perception, coping, worsening condition; Barriers: trust vs. mistrust, lack of continuity, communication, self-medicating, side effects, economics, patient education, patient lifestyle; Benefits: understand medications, personal health feelings; and finally, Cues: knowledge, communication, social support, and general cues. The cessation of medication is multifactorial and could be influenced not only by patients, but also by clinicians, health plan payors and healthcare systems. Analysis of interviews with these stakeholders is currently underway. Improved recognition of patients at risk for discontinuing medication and understanding the behavior triggers can lead to tailored and innovative strategies for overcoming existing barriers associated with the premature discontinuation of Plavix therapy.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleBarriers to Good Therapy: Patients', Physicians', and Health Plan Providers' Perspectives of Acute Myocardial Infarction Patients' Discontinuation of Plavixen_GB
dc.identifier.urihttp://hdl.handle.net/10755/159655-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Barriers to Good Therapy: Patients', Physicians', and Health Plan Providers' Perspectives of Acute Myocardial Infarction Patients' Discontinuation of Plavix</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2007</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Decker, Carole, PhD, RN</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">Mid America Heart Institute</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">CV Research, 4401 Wornall Road, Kansas City, MO, 64111, USA</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">c1decker@saint-lukes.org</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">B. Garavalia and J.A. Spertus, Cardiovascular Research, Mid America Heart Institute, Kansas City, MO and L. Garavalia, Department of Psychology, University of Missouri-Kansas City, Kansas City, MO</td></tr><tr><td colspan="2" class="item-abstract">Background &amp; Objective: An earlier quantitative study from our group indicated 14% of MI patients discontinue thienopyridines (antiplatelet therapy, Plavix) at 1 month after receiving a drug-eluting stent. Patients who discontinued Plavix early were 9 times more likely to die or have a cardiac rehospitalization within 1 year than those who continued the medication. The purpose of this study is to examine patient, clinician, and health plan provider perspectives to understand why patients discontinue Plavix prior to recommended duration, presenting patient results here. Subjects &amp; Methods: We recently performed in-depth qualitative research with MI Registry patients who reported stopping Plavix during their 1 month follow-up visit. The ongoing TRIUMPH Registry is enrolling MI patients at 19 centers across the US and includes detailed interview and clinical elements, plus follow-up interviews at 1, 6, and 12 months following the MI. The Health Belief Model (HBM) was utilized as the framework for question development. A trained health interviewer conducted and recorded the 30 minute interview by phone. The tapes were transcribed, coded, and then analyzed by three experienced researchers. Results &amp; Conclusions: Twelve MI patients who reported stopping Plavix at 1 month were interviewed, having reached data saturation. The main themes emerged set in the HBM were: Severity: recognition vs. non recognition, good health; Threat: accurate vs. inaccurate perception, coping, worsening condition; Barriers: trust vs. mistrust, lack of continuity, communication, self-medicating, side effects, economics, patient education, patient lifestyle; Benefits: understand medications, personal health feelings; and finally, Cues: knowledge, communication, social support, and general cues. The cessation of medication is multifactorial and could be influenced not only by patients, but also by clinicians, health plan payors and healthcare systems. Analysis of interviews with these stakeholders is currently underway. Improved recognition of patients at risk for discontinuing medication and understanding the behavior triggers can lead to tailored and innovative strategies for overcoming existing barriers associated with the premature discontinuation of Plavix therapy.</td></tr></table>en_GB
dc.date.available2011-10-26T22:12:50Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T22:12:50Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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