Barriers to the use of DOACS within local health economies
Research type
Research Study
Full title
A study of barriers and enablers in the introduction of direct oral anticoagulants approved by NICE into patient care
IRAS ID
237794
Contact name
Kristina Medlinskiene
Contact email
Sponsor organisation
University of Bradford
Duration of Study in the UK
2 years, 4 months, 20 days
Research summary
Atrial fibrillation (or AF), the most common heart rhythm disturbance, greatly increases a person’s risk of stroke. AF-related strokes can be prevented with blood-thinning medicines. Warfarin, a traditional blood-thinning medicine, has been used for many years. In the past five years, we have seen new blood-thinning medicines called direct oral anticoagulants (DOACs) being used. There are particular reasons why DOACs, such as apixaban, dabigatran, edoxaban and rivaroxaban, may be preferred over warfarin. Despite advantages of DOACs (e.g. less monitoring, simpler dosing regimens) their national up take has been slower and lower in the United Kingdom (UK) compared to other European countries. Also, some areas in the UK use a lot of DOACs and some areas very little. This suggests that patients with AF may be offered different blood-thinning therapy options depending on where they live.
This qualitative study aims to understand:
• Why the use of DOACs is different between Bradford, Leeds and Sheffield areas;
• What helps or stops the use of new medicines like DOACs in Bradford, Leeds, and Sheffield areas.The study has three phases:
1. Review of published evidence;
2. a) Non-participant observation of meetings where decisions about local use of DOACs are made and analysis of documents produced for the local use of DOACs b) Interviews with patients with AF who take blood-thinning medicines to learn about their experiences.
3. Interviews with healthcare professionals, people involved in making DOACs available locally, and people from pharmaceutical companies supplying DOACs to understand their views on what helps or stops DOACs use locally.I will produce recommendations on how to improve availability of medicines like DOACs in local NHS organisations so that more patients have access to and can benefit from them.
Results of the study will be shared with patients and the public, healthcare professionals, academia, and commissioning organisations.
REC name
South Central - Oxford B Research Ethics Committee
REC reference
18/SC/0284
Date of REC Opinion
19 Jun 2018
REC opinion
Further Information Favourable Opinion