Facilitators and Barriers of Oral Anticoagulant Use in Patients: A Qualitative study

Background: Oral anticoagulants are medications that offer improvement in the quality of life by preventing life threatening thromboembolic complications. The risk benefit profile favouring` the use of these lifesaving medications is influenced by the unique socio-cultural factors that affect the adherence to these medications. The objective is to explore the patient’s experiences, barriers and facilitators regarding oral anticoagulant (OAC) use in the Indian context. Material and Methods: A phenomenology study was conducted in the departments of cardiothoracic surgery and pharmacology of a government institution in Central Kerala to explore the lived experiences of patients and the challenges faced by them regarding the use of OACs. The study period was six months (March -August 2025) after obtaining the IRB clearance (IRB 189/2024 dated 05.11.2024). Data were collected through semi-structured, in-depth interviews with patients taking OACs for more than one month. Sampling followed a purposive strategy and data collection continued till data saturation was achieved. After transcription of the audio files thematic analysis was done using QDA Miner Lite software. Results: Out of the 276 codes representing 170 facilitators and 106 barriers, four major themes evolved. Comprehension, Adherence, Safety Concerns and Expectations were the major themes. Strong daily routines related to life events served as a major facilitator. Barriers included significant gaps in indication of the medicine, bleeding concerns and competing symptom burden overshadowed the perceived benefits of OAC. Conclusion: While adherence was strongly linked to habit and family support there were critical barriers like knowledge gaps in terms of medication indication and expectation as well as safety concerns. Patient education can significantly bridge the gap in strengthening the facilitators and abolishing the barriers.

Keywords: Oral Anticoagulants, Medication Adherence, Qualitative Research, Patient Perspective.