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Avoidance hierarchies and preferences for anticoagulation--semi-qualitative analysis of older patients' views about stroke prevention and the use of warfarin

Fuller, Richard, Dudley, Nigel and Blacktop, Jon (2004) Avoidance hierarchies and preferences for anticoagulation--semi-qualitative analysis of older patients' views about stroke prevention and the use of warfarin. Age and Ageing, 33 (6). pp. 608-611. ISSN 0002-0729

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Abstract

Objective: To examine older patients' preferences regarding the use of warfarin to prevent atrial fibrillation related strokes when faced with cumulative probabilities of treatment risk and benefit.

Design: A semi-qualitative researcher administered questionnaire and interview.

Subjects: 81 patients attending a general elderly medicine outpatient clinic.

Results: Up to 50% of participants would decline warfarin treatment when shown both cumulative benefits of stroke risk reduction and risk of intracerebral haemorrhage. Principal themes highlighted concepts of gambling and trade offs relating to risk and benefit. Attitudes about stroke and negative perceptions of intracerebral haemorrhage were major contributory themes in the decision to refuse warfarin treatment.

Conclusion: Older people use very individualistic health beliefs in judging how to trade risks to preserve quality of life. Carefully explaining risk information and listening to elders' views and reasoning is likely to result in a more informed choice regarding the use of anticoagulation in stroke prevention.

Keywords: stroke, anticoagulation, risk, patient preferences, elderly

Item Type: Article
Subjects: R Medicine > R Medicine (General)
Schools: School of Human and Health Sciences
School of Human and Health Sciences > Centre for Applied Childhood Studies
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Depositing User: Catherine Parker
Date Deposited: 22 Jul 2008 11:31
Last Modified: 04 Jan 2011 13:27
URI: http://eprints.hud.ac.uk/id/eprint/1163

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