The Patient-physician Relationship: Experiences of Atrial Fibrillation and Anticoagulation Therapy
C. Borg-Xuereb, R. L. Shaw, G. Y.H. Lip, D. A. Lane
School of Life & Health Sciences, Aston University, Birmingham, UK. University of Birmingham Centre for Cardiovascular Sciences, City Hospital, Birmingham, UK
Background: Oral anticoagulation (OAC) reduces stroke risk in patients with atrial fibrillation (AF) however it is often underutilized and sometimes refused by patients. Two inter-linking studies aimed to explore patients’ and physicians’ experiences of AF and OAC. Methods: Study 1: Three AF patient sub-groups were interviewed (n=11); accepted, refused, or discontinued OAC. Study 2: Four physician sub-groups (n=16) were interviewed: consultant cardiologists, general physicians, general practitioners and cardiology registrars. Data was analysed using IPA. Results: Three main themes comprised patients’ experiences: the initial consultation, life after the consultation, and patients’ reflections. Two main themes emerged from physicians’ experiences: communicating information and challenges with OAC prescription for AF. Discussion: This programme of work has illustrated the benefit of taking an in depth phenomenological approach to understanding the lived experience of the physician- patient consultation. This work has strengthened the evidence base and demonstrated that there is a need to target patients' and physicians' ability to communicate with each other in a comprehensible way.