Patient Attitudinal & BehaviouralFactors Associated withWarfarinNon-Adherence atOutpatient Anticoagulation ClinicsCritique...
Why?1. “patient factors underscore effectivewarfarin use”2. “Wide range of potential influences”3. “Limited data on attitu...
Led to the Aim…“TO EXAMINE SPECIFIC PATIENT FACTORSTHAT MIGHT HELP EXPLAIN WARFARINNON-ADHERENCE AT OUTPATIENTANTICOAGULAT...
Method• How did they…– Measure Adherence?• MEMS Pill Caps (Medication Event MonitoringSystems)– Measure Factors/Behavior?•...
So…• Hypothesis?• A Clear Focused Issue?– Population• Who was excluded?– Benefit VS Harms– Outcomes• Comparable? Answer qu...
Was the method appropriate forthe question?Patient Attitudinal and Behavioral Factors Associated with WarfarinNon-Adherenc...
Results and Discussion• What were the results?– Adherence &non-adherence– Relationship between MBMD & non-adherence?• How ...
Conclusions• Author’s conclusions– “Lack of receptivity to details”– Aim answered• MY CONCLUSIONS– Clear rationale– Clinic...
Future Work• Limitations?– Other factors– Use of Pill Caps– Other clinic settings• Work implied for future?– Larger patien...
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Critique Presentation - Amandeep Birdi

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A Critique Presentation of the paper "Patient Attitudinal and Behavioral Factors Associated with Warfarin Non-adherence at Outpatient Anticoagulation Clinics" as part of the module "Research Methods" at the University of Hertfordshire for my third year of the MPharm degree.

Dean G. Cruess & A. Russell Localio & Alec B. Platt & Colleen M. Brensinger & Jason D. Christie & Robert Gross & Catherine S. Parker & Maureen Price & Joshua P. Metlay & Abigail Cohen & Craig W. Newcomb & Brian L. Strom & Stephen E. Kimmel

Published in the international Journal of Behavioural Medicine

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Critique Presentation - Amandeep Birdi

  1. 1. Patient Attitudinal & BehaviouralFactors Associated withWarfarinNon-Adherence atOutpatient Anticoagulation ClinicsCritique PresentationAmandeep BirdiDean G. Cruess, A. Russell Localio, Alec B. Platt, Colleen M. Brensinger, Jason D. Christie, Robert Gross, CatherineS. Parker, Maureen Price, Joshua P. Metlay, Abigail Cohen, Craig W. Newcomb, Brian L. Strom, Stephen E. Kimmel
  2. 2. Why?1. “patient factors underscore effectivewarfarin use”2. “Wide range of potential influences”3. “Limited data on attitudinal andbehavioral factors”Patient Attitudinal and Behavioral Factors Associated with WarfarinNon-Adherence at Outpatient Anticoagulation Clinics
  3. 3. Led to the Aim…“TO EXAMINE SPECIFIC PATIENT FACTORSTHAT MIGHT HELP EXPLAIN WARFARINNON-ADHERENCE AT OUTPATIENTANTICOAGULATION CLINICS”Patient Attitudinal and Behavioral Factors Associated with WarfarinNon-Adherence at Outpatient Anticoagulation ClinicsTo find out the reasons why patients arenot adhering to their Warfarin whenthey leave Anticoagulation Clinics
  4. 4. Method• How did they…– Measure Adherence?• MEMS Pill Caps (Medication Event MonitoringSystems)– Measure Factors/Behavior?• Million Behavioral Medicine Diagnostic(MBMD)Patient Attitudinal and Behavioral Factors Associated with WarfarinNon-Adherence at Outpatient Anticoagulation Clinics
  5. 5. So…• Hypothesis?• A Clear Focused Issue?– Population• Who was excluded?– Benefit VS Harms– Outcomes• Comparable? Answer question?Patient Attitudinal and Behavioral Factors Associated with WarfarinNon-Adherence at Outpatient Anticoagulation Clinics
  6. 6. Was the method appropriate forthe question?Patient Attitudinal and Behavioral Factors Associated with WarfarinNon-Adherence at Outpatient Anticoagulation ClinicsTherefore…
  7. 7. Results and Discussion• What were the results?– Adherence &non-adherence– Relationship between MBMD & non-adherence?• How reliable?– Confidence levels– Biased?• Statistics– Clearly show result?Patient Attitudinal and Behavioral Factors Associated with WarfarinNon-Adherence at Outpatient Anticoagulation Clinics
  8. 8. Conclusions• Author’s conclusions– “Lack of receptivity to details”– Aim answered• MY CONCLUSIONS– Clear rationale– Clinically relevant and significant result– Further studies required in other clinicalsettings– Written and presented wellPatient Attitudinal and Behavioral Factors Associated with WarfarinNon-Adherence at Outpatient Anticoagulation Clinics
  9. 9. Future Work• Limitations?– Other factors– Use of Pill Caps– Other clinic settings• Work implied for future?– Larger patient samplesPatient Attitudinal and Behavioral Factors Associated with WarfarinNon-Adherence at Outpatient Anticoagulation Clinics
  10. 10. Thank you for listening!

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