Exploring Experiences and Challenges in Caring for Patients Receiving Warfarin Therapy in Community Hospitals: A Qualitative Study
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Abstract
Objectives: To investigate the experiences, needs, and challenges of patients receiving warfarin therapy, as well as the perspectives of the healthcare team regarding service delivery in a community hospital. Furthermore, it sought to identify pain points and opportunities for service system improvement utilizing the concept on service design. Methods: This qualitative study was conducted between April and June 2025 at a warfarin clinic in a community hospital in Sakon Nakhon Province. Informants consisted of 10 patients, 2 caregivers, and 8 healthcare providers. Data were collected through in-depth interviews and focus group discussions using semi-structured interview guides. Qualitative data were analyzed using content analysis and synthesized using the service design framework. Results: Patients and caregivers highlighted critical challenges regarding barriers to service accessibility, dependence on caregivers, knowledge and beliefs concerning medications, and daily drug-use behaviors. The multidisciplinary healthcare team expressed concerns regarding role ambiguity, fragmented care processes, limitations in information systems and clinical decision support tools, as well as constraints in patient education and follow-up care. The synthesis of these findings led to the development of four distinct patient personas and comprehensive service journey maps. These tools effectively visualized pain points and identified developmental opportunities across all phases of care. Proposed service interventions included proactive patient follow-up systems, clinical decision support tools, and tailored educational models suited to each patient persona. Conclusion: The application of service design concept successfully integrated the perspectives of patients, caregivers, and healthcare providers, enabling a holistic understanding of systemic challenges in community hospital-based warfarin care. These insights serve as a foundational framework for developing service systems that enhance continuity of care, patient safety, and alignment with patients' real-world contexts.
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ผลการวิจัยและความคิดเห็นที่ปรากฏในบทความถือเป็นความคิดเห็นและอยู่ในความรับผิดชอบของผู้นิพนธ์ มิใช่ความเห็นหรือความรับผิดชอบของกองบรรณาธิการ หรือคณะเภสัชศาสตร์ มหาวิทยาลัยสงขลานครินทร์ ทั้งนี้ไม่รวมความผิดพลาดอันเกิดจากการพิมพ์ บทความที่ได้รับการเผยแพร่โดยวารสารเภสัชกรรมไทยถือเป็นสิทธิ์ของวารสารฯ
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