Dual antiplatelet therapy prescribing in the UK: a mixed methods study
Research type
Research Study
Full title
Clinician and patient factors influencing dual antiplatelet therapy (DAPT) prescribing in patients undergoing coronary interventions in the UK: a mixed method study.
IRAS ID
203302
Contact name
Maria Pufulete
Contact email
Duration of Study in the UK
0 years, 1 months, 24 days
Research summary
Antiplatelet drugs are prescribed to all people diagnosed with acute coronary syndrome (heart attack or unstable angina) and work by preventing the formation of blood clots. It is most commonly prescribed as a combination of low dose aspirin and an additional antiplatelet drug; clopidogrel, prasugrel or ticagrelor, which is referred to as ‘dual antiplatelet therapy’ (DAPT).
DAPT increases the risk of both major and minor bleeding. Some patients are also prescribed an anticoagulant in addition to DAPT, which further increases bleeding risk. However, the extent to which bleeding is experienced by patients is not currently known.
We are conducting a study (the ADAPTT study) to determine how many people experience bleeding after being prescribed DAPT, or DAPT and an anticoagulant, by using a large routinely collected dataset from the Clinical Practice Research Datalink (CPRD) and hospital Episode Statistics (HES). However, there is currently little understanding about different clinicians’ prescribing practice, both in primary care and secondary care. We do not know what prompts clinicians to prescribe different DAPT regimens to different patients.
We propose to conduct a mixed-methods study involving clinicians and patients to identify factors that influence prescribing practice among clinicians, reasons why patients continue to take or cease their DAPT medication and factors affecting patients' quality-of-life. We will do this in the first instance by conducting semi-structured one-to-one interviews with clinicians (cardiologists, cardiac surgeons and general practitioners (GPs)), followed by a questionnaire that will elicit further data from a wider group of clinicians. We will also conduct four patient focus groups to identify patient initiated factors and determine how bleeding influences quality of life. The findings from both clinicians and patients will provide important contextual information for the ADAPTT study, which will help to explain any variations found in the routinely collected data.
REC name
South West - Cornwall & Plymouth Research Ethics Committee
REC reference
17/SW/0092
Date of REC Opinion
2 May 2017
REC opinion
Further Information Favourable Opinion