An Underappreciated and Prolonged Drug Interaction Leads to Ineffective Anticoagulation

Rogers, Kelly C.; Neu, Daniel; Jaeger, Melanie C; Shah, Rahman; Finks, Shannon W.

doi:10.14423/smj.0000000000000926

Cited by 5 publications

(1 citation statement)

References 11 publications

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“…These clinical effects include reduced mortality and complications [29][30][31][32] , reduced healthcare utilization and fewer hospitalizations [32][33][34][35][36][37] , reduced 30-day readmission rate 29,32,[38][39][40][41][42][43][44][45][46] , reduced visits to the emergency department 32,34,37,45 , and shorter lengths of hospital stay (LOS) 29,31,47 . In addition, insufficient continuity is associated with inappropriate prescription medications (i.e., the use of drugs that should be avoided due to the high risk of adverse events) in patients with comorbidity 37 and serious adverse drug reactions in patients with atrial fibrillation using oral anticoagulation 48,49 .…”

Section: Continuity Of Carementioning

confidence: 99%

Continuity of care after hospitalization due to cardiac conditions : Patients' perceptions, validity and reliability of a measure, and associations with outcomes

Säfström

2023

Linköping University Medical Dissertations

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Background: Cardiac conditions are a common cause of hospitalization worldwide. The need for healthcare continues after hospital discharge and most commonly includes follow-up within primary healthcare centers or specialized outpatient cardiology clinics. This transition from the hospital to outpatient or primary-care settings jeopardizes the continuity of care. Continuity of care refers to the coordination of healthcare between different healthcare personnel and settings over time. There are three types of continuity of care: informational, relational, and management continuity. Continuity of care is essential after hospitalization due to cardiac conditions, and is associated with several positive clinical outcomes; however, available patient-reported measures of continuity of care during the posthospital period needs further validation. Accurate measurements would improve our ability to evaluate implementations designed to enhance continuity of care. Moreover, there is a lack of knowledge about whether the associations between continuity of care, perceived control, and self-care could explain variations in health-related quality of life and hospital readmissions in patients with cardiac conditions. Aim:The overall aim of this thesis was to contribute to improving care after hospitalization for patients with cardiac conditions by describing continuity of care from the patient's perspective and increasing the understanding of how continuity of care can be measured and how it can influence patient outcomes. Method:All four studies had a cross-sectional design using a consecutive sampling procedure (I-IV). Study I was a single-center study and studies II-IV were multicenter studies. Data was collected using structured telephone interviews (I), questionnaires (II-IV), and review of medical charts (I-IV). The timescale for data collection ranged from one week (I) to six weeks after discharge (II-IV). The Patient Continuity of Care Questionnaire (PCCQ), a 27-item questionnaire to measure patients' perceptions of continuity of care, was translated and culturally adapted to Swedish. The factor structure was reviewed (II), and a short version including 12 of the items was evaluated (III). A conceptual model was constructed to examine the associations between continuity of care, perceived control, self-care, health-related quality of life, and hospital readmissions (IV). The data was analyzed using descriptive and non-parametric statistics (I), confirmatory factor analysis, test-retest estimation (II), the Rasch measurement model (III), and structural equation modeling (SEM) (IV).

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