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Uphold CR, Wilson D, Beyth RJ, Treise D, Wing KL, Hanjian J, Shorr R. Direct-to-Consumer Approach to Improve Outcomes in Atrial Fibrillation. Poster session presented at: VA QUERI National Meeting; 2008 Dec 11; Phoenix, AZ.
Objectives: The overall aim was to extend our line of research on improving guideline adherence for prescribing anti-thrombotics to patients with atrial fibrillation (AF). Our goal was to use a direct-to-consumer approach and persuade patients to ask their providers about anti-thrombotics. Specifically, our aims were to 1) describe veterans' perceptions of AF, anti-thrombotics, and shared decision-making, and 2) develop and evaluate a script and video design to improve shared decision-making related to stroke prevention. Methods: We conducted face-to-face qualitative interviews with patients who had AF. We analyzed the data with constant-comparative methods using NVivo (N7). We conducted marketing research to determine the best venues for persuading our target audience. Our findings were used to develop a video script and design. Results: In the interviews, patients were concerned about the risks of bleeding, taking a medication that was labelled "rat poison," and about the need for frequent blood tests. Although most patients wanted to be involved in decision making, they also said they would defer to the advice of their providers. Our marketing research found that for our target audience (older persons with atrial fibrillation), day-time TV was the venue most used to obtain information. In particular, the Golf Station, Nickolodean, and the classic movie station were the most frequently viewed. We developed a video design and script that incorporated the marketing research results and findings from the qualitative interviews. Implications: Direct-to-consumer marketing approaches are important strategies for improving shared decision-making related to stroke prevention. Impacts: By partnering with experts in other disciplines (i.e., journalism, communication, business), health services researchers developed a video script and design to improve outcomes of patients with atrial fibrillation.
