DECISIONS: Development of an intervention for anticoagulation
Research type
Research Study
Full title
DECISIONS: DEvelopment of a Comprehensive Intervention to Support Individuals with anticoagulatiON to prevent Stroke
IRAS ID
252103
Contact name
Josephine M.E. Gibson
Contact email
Duration of Study in the UK
1 years, 11 months, 30 days
Research summary
This project will develop new ways of working to help people who require stroke-preventing oral anticoagulants (‘blood-thinning’ medicines) to obtain and manage the treatment they need. Atrial fibrillation, an irregular heartbeat, affects 1.3 million UK adults. It can cause a blood clot to travel from heart to brain, blocking the circulation and causing a stroke. Certain other heart and circulation conditions can also cause these problems. These risks can be greatly reduced with anticoagulants. However, these also increase the risk of serious or fatal bleeding. Warfarin has been used for anticoagulation for many years, but it requires regular monitoring of blood clotting and dosage changes, usually in hospital clinics. Recent treatment developments include better ways of assessing people’s risks of stroke and bleeding, new medicines which are simpler to take, care in general practices instead of hospitals, and home-testing of blood clotting. However, many people do not take the medicines correctly or even receive them. These problems may differ between drug types.
Better managed treatment could prevent more strokes. This project aims to improve anticoagulation care management. Initially: working with six general practices to observe current anticoagulation care and potential improvements. Next: interviews with around 24 staff, 20 patients, and 10 carers about their anticoagulation care experiences. Finally: working with patients, carers and practices to develop a new pathway, including ways to identify who needs anticoagulants, decision-support about starting treatment, choice of medicine, monitoring and support, and problem resolution. The project is supported by patient representatives from a local hospital and support groups. Two members of the public will help to oversee the project. We will also invite people from the six general practices to contribute. Further grant funding could test the care pathway. We will share findings with patient groups, health care staff and researchers.REC name
South West - Central Bristol Research Ethics Committee
REC reference
20/SW/0044
Date of REC Opinion
22 Apr 2020
REC opinion
Further Information Favourable Opinion