Barriers and facilitators for improving oral anticoagulant medication adherence in lower extremity deep venous thrombosis patients after spinal surgery: A qualitative study using the COM-B model.

Xiaoyu Wu, Huaqin Wang, Ya Tan, Xiaoju Tan, Xinge Zhao, Xiaoling Liu, Wenli Wang
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Abstract

Background: Deep venous thrombosis (DVT) of the lower extremity causes a major disease burden globally. Currently, oral anticoagulant therapy is used as the first-line treatment of DVT, however, medication non-adherence remains a serious problem for postoperative spinal surgery patients whose DVT incidence is at a high level.

Aims: To explore barriers and facilitators affecting patient oral anticoagulant medication adherence, based on guidance using the COM-B model.

Methods: This study was a qualitative study using a descriptive research design with in-depth and semi-structured interviews. Data were analyzed adopting traditional content analysis methods.

Results: Based on the COM-B theoretical model, we identified 9 barriers and facilitators from capability, opportunity, and motivation domains.

Conclusions: Patients were confronted with barriers from capability, opportunity, and motivation domains, which were not isolated but interrelated. Future interventions should incorporate facilitators and barriers to address medication adherence issue with a holistic approach at multiple levels.

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脊柱术后下肢深静脉血栓患者口服抗凝药物依从性改善的障碍和促进因素:一项使用COM-B模型的定性研究
背景:下肢深静脉血栓形成(DVT)是全球范围内的主要疾病负担。目前,口服抗凝治疗是DVT的一线治疗方法,但对于DVT发生率较高的脊柱术后患者,药物依从性仍然是一个严重的问题。目的:基于COM-B模型的指导,探讨影响患者口服抗凝药物依从性的障碍和促进因素。方法:本研究采用定性研究,采用深度访谈和半结构化访谈的描述性研究设计。数据分析采用传统的内容分析方法。结果:基于COM-B理论模型,我们从能力、机会和动机三个方面确定了9个障碍和促进因素。结论:患者面临着能力、机会和动机领域的障碍,这些障碍不是孤立的,而是相互关联的。未来的干预措施应结合促进因素和障碍,以多层次的整体方法解决药物依从性问题。
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CiteScore
2.60
自引率
14.30%
发文量
34
期刊最新文献
Validity and reliability of the Danish version of the Hospital Anxiety and Depression Scale (HADS) in patients with major lower extremity amputations: A psychometric study. Barriers and facilitators for improving oral anticoagulant medication adherence in lower extremity deep venous thrombosis patients after spinal surgery: A qualitative study using the COM-B model. Editorial February 2025 issue - Authors Prof Rebecca Jester and Paul McLiesh. Corrigendum to "Patient participation in orthopaedic care-a survey on hip surgery patients' preferences for and experiences of engagement in their health and healthcare" [Int. J. Orthop. Trauma Nurs. 54 (2024) 101118]. Literature reviews – External fixation pin site infections: Solutions, screws and Kwires
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