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

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.