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Erschienen in: Journal of Thrombosis and Thrombolysis 3/2018

08.02.2018

Mind the gap: results of a multispecialty survey on coordination of care for peri-procedural anticoagulation

verfasst von: Jacob E. Kurlander, Geoffrey D. Barnes, Michelle A. Anderson, Brian Haymart, Eva Kline-Rogers, Scott Kaatz, Sameer D. Saini, Sarah L. Krein, Caroline R. Richardson, James B. Froehlich

Erschienen in: Journal of Thrombosis and Thrombolysis | Ausgabe 3/2018

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Abstract

To understand how physicians from various specialties perceive coordination of care when managing peri-procedural anticoagulation. Cross-sectional survey of cardiologists, gastroenterologists, and primary care physicians (PCPs) in an integrated health system (N = 251). The survey began with a vignette of a patient with atrial fibrillation co-managed by his PCP, cardiologist, and an anticoagulation clinic who must hold warfarin for a colonoscopy. Respondents’ experiences and opinions around responsibilities and institutional support for managing peri-procedural anticoagulation were elicited using multiple choice questions. We examined differences in responses across specialties using Chi square analysis. The response rate was 51% (n = 127). 52% were PCPs, 28% cardiologists, and 21% gastroenterologists. Nearly half (47.2%) of respondents believed that the cardiologist should be primarily responsible for managing peri-procedural anticoagulation, while fewer identified the PCP (25.2%), anticoagulation clinic (21.3%), or gastroenterologist (6.3%; p = 0.09). Respondents across specialties had significantly different approaches to deciding how to manage the clinical case presented (p < 0.001). Most cardiologists (60.0%) would decide whether to offer bridging without consulting with other providers or clinical resources, while most PCPs would decide after consulting clinical resources (57.6%). Gastroenterologists would most often (46.2%) defer the decision to another provider. A majority of all three specialties agreed that their institution could do more to help manage peri-procedural anticoagulation, and there was broad support (88.1%) for anticoagulation clinics’ managing all aspects of peri-procedural anticoagulation. Providers across specialties agree that their institution could do more to help manage peri-procedural anticoagulation, and overwhelmingly support anticoagulation clinics’ taking responsibility.
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Metadaten
Titel
Mind the gap: results of a multispecialty survey on coordination of care for peri-procedural anticoagulation
verfasst von
Jacob E. Kurlander
Geoffrey D. Barnes
Michelle A. Anderson
Brian Haymart
Eva Kline-Rogers
Scott Kaatz
Sameer D. Saini
Sarah L. Krein
Caroline R. Richardson
James B. Froehlich
Publikationsdatum
08.02.2018
Verlag
Springer US
Erschienen in
Journal of Thrombosis and Thrombolysis / Ausgabe 3/2018
Print ISSN: 0929-5305
Elektronische ISSN: 1573-742X
DOI
https://doi.org/10.1007/s11239-018-1625-2

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