一项定性研究评估了医疗服务提供者对实施华法林患者自我管理在美国医疗保健系统中的看法
Aaron S Wilson1, Stacey Slager1, Aubrey E Jones1,2
1Pharmacotherapy Department, University of Utah College of Pharmacy, Salt Lake City, Utah, USA.
概括
华法林患者自我管理 (PSM) 在美国由于提供者对患者安全和能力的担忧而未得到充分利用. 克服这些障碍需要有针对性的教育和实施战略,以实现更广泛的采用.
科学领域:
- 药理学和治疗学 药理学和治疗学
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
背景情况:
- 华法林患者自我管理 (PSM) 在美国的采用明显落后于欧洲国家,尽管有指导方针建议.
- 了解美国医疗保健系统中的具体障碍和促进因素对于改善PSM实施至关重要.
研究的目的:
- 探讨美国抗凝管理服务提供商关于华法林PSM的障碍和促进者的观点.
- 确定影响美国采用和使用PSM的关键因素.
主要方法:
- 与29家美国抗凝血管理服务提供商在五个不同的地理位置进行了焦点小组讨论.
- 以"实施研究综合框架" (CFIR) 为指导的基础理论分析被用来分析定性数据.
主要成果:
- 关键主题包括提供者对理想PSM候选人的看法,提供者对PSM的恐惧和缺乏熟悉,以及对患者能力的不信任.
- 工作流的问题和对最佳患者培训策略的不同意见也成为PSM实施的重大障碍.
- 医疗服务提供者对患者安全的担忧和不愿意放弃控制是采取PSM时犹的核心原因.
结论:
- 由于患者安全问题和不信任,提供者担忧阻碍了华法林在美国的PSM采用.
- 有效的教育和量身定制的实施策略对于解决这些障碍和促进PSM更广泛使用至关重要.
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