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Anticoagulated patient’s perception of their illness, their beliefs about the anticoagulant therapy prescribed and the relationship with adherence: impact of novel oral anticoagulant therapy – study protocol for The Switching Study: a prospective cohort study

Research output: Contribution to journalArticle

Wai Yee Vivian Auyeung, Jignesh Prakash Patel, John Kyrillos Abdou, Bipin Vadher, Lynda Bonner, Alison Brown, Lara N. Roberts, Raj K Patel, Roopen Arya

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalBMC Hematology
Issue number22
Publication statusPublished - 23 Aug 2016


King's Authors


Background Anticoagulant therapy is prescribed for millions of patients worldwide for the prevention and treatment of both arterial and venous thrombosis. Historically, only vitamin K antagonists have been available for clinicians to prescribe. The anticoagulation landscape is changing. The recent availability of the novel oral anticoagulants overcome many of the disadvantages associated with vitamin K antagonists. However the lack of formal monitoring and clinic follow-up is a concern for clinicians, as medication adherence is being assumed, which is known to decline in patients prescribed medications for chronic conditions. The switching study is a programme of work investigating the association between medication adherence and patient’s beliefs about anticoagulation therapy (warfarin and subsequently novel oral anticoagulants), together with beliefs about their illness and anticoagulation related quality of life.Methods/designThe anticoagulation database at King’s College Hospital will be interrogated and two groups of patients will be identified; those with a time in therapeutic range on warfarin of ≥75 % and those <50 %. These groups of patients will have their illness perceptions, anticoagulation specific quality of life and beliefs about medications compared. Those patients in the time in therapeutic range <50 % group, will be then be invited to switch to a novel oral anticoagulant, as per local guidance. Those patients, who do switch, will then be followed longitudinally and have their adherence, illness perceptions, anticoagulation specific quality of life and beliefs about medications, re-evaluated on the novel agent. The results from these sub-studies, will inform a clinical pathway to support patients on these novel agents, which will be evaluated in an independent group of patients.DiscussionThe results from the switching study will be used to develop a clinical pathway to support patient’s prescribed novel oral anticoagulant therapy long-term.

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