Prevention of hospital-acquired thrombosis from a primary care perspective: a qualitative study

被引:2
|
作者
Litchfield, Ian [1 ]
Fitzmaurice, David [2 ]
Apenteng, Patricia [3 ]
Harrison, Sian [4 ]
Heneghan, Carl [5 ]
Ward, Alison [6 ]
Greenfield, Sheila [3 ]
机构
[1] Univ Birmingham, Coll Med & Dent Sci, Inst Appl Hlth Res, Birmingham B15 2TT, W Midlands, England
[2] Univ Birmingham, Coll Med & Dent Sci, Primary Care Clin Sci, Birmingham B15 2TT, W Midlands, England
[3] Univ Birmingham, Coll Med & Dent Sci, Med Sociol, Birmingham B15 2TT, W Midlands, England
[4] Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Oxford OX1 2JD, England
[5] Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Evidence Based Med, Oxford OX1 2JD, England
[6] Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Postgrad Studies, Oxford OX1 2JD, England
来源
BRITISH JOURNAL OF GENERAL PRACTICE | 2016年 / 66卷 / 649期
基金
美国国家卫生研究院;
关键词
prevention and control; primary health care; qualitative research; thrombosis; DEEP-VEIN THROMBOSIS; VENOUS THROMBOEMBOLISM; MEDICATION DISCREPANCIES; COMMUNICATION; PROPHYLAXIS; DISCHARGE; RISK; IMPACT; THROMBOPROPHYLAXIS; NONADHERENCE;
D O I
10.3399/bjgp16X685693
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background Although there is considerable risk for patients from hospital-acquired thrombosis (HAT), current systems for reducing this risk appear inefficient and have focused predominantly on secondary care, leaving the role of primary care underexplored, despite the onset of HAT often occurring post-discharge. Aim To gain an understanding of the perspectives of primary care clinicians on their contribution to the prevention of HAT. Their current role, perceptions of patient awareness, the barriers to better care, and suggestions for how these may be overcome were discussed. Design and setting Qualitative study using semi-structured interviews in Oxfordshire and South Birmingham, England. Method Semi-structured telephone interviews with clinicians working at practices of a variety of size, socioeconomic status, and geographical location. Results A number of factors that influenced the management of HAT emerged, including patient characteristics, a lack of clarity of responsibility, limited communication and poor coordination, and the constraints of limited practice resources. Suggestions for improving the current system include a broader role for primary care supported by appropriate training and the requisite funding. Conclusion The role of primary care remains limited, despite being ideally positioned to either raise patient awareness before admission or support patient adherence to the thromboprophylaxis regimen prescribed in hospital. This situation may begin to be addressed by more robust lines of communication between secondary and primary care and by providing more consistent training for primary care staff. In turn, this relies on the allocation of appropriate funds to allow practices to meet the increased demand on their time and resources.
引用
收藏
页码:E593 / E602
页数:10
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