Table 2 Physicians’ quotations

Information to reinforce anticoagulation use

… although you may have, um, read things, eventually you stick to your experience, right? You can read that statistically the probability is low but if you have face a few cases… you don’t act in the same manner.’ (Family doctor, Spain) [37].

. . . if someone comes to you with atrial fibrillation you want to know, if he’s the average man in the street, what am I best to treat him with and that’s . . .that’s not answered by studies that have 80% exclusion rates.” (Family physician, UK) [29].

Balance of benefits and downsides

“… I believe that in the fibrillation treatment the benefits, I think of those moments where benefits are observed, regardless of the risk of the therapy in itself…” (Family physician, Spain) [37].

“Ideally you would want to treat this lady with warfarin but in view of the recurrent falls and the subsequent risk of life-threatening haemorrhage l would opt for the lesser antithrombotic of either aspirin or clopidogrel” (Hospital family physicians, UK) [34].

Roles in decision-making and therapy management

“Patients have wonderful trust in their GPs, which we don’t want to interfere with, but they do seem to think that the GP is going to remember and know every detail.” (Hospital pharmacist, Australia) [29].

“…I’m not so much convinced that it should be on me to decide on the indications, it’s far from clear to me (…), on one hand, and then, I get really angry when other specialists decide on the indication, which may be appropriate but they do it with no knowledge of the patient’s social history whatsoever…” (Family physician, Spain) [37].

Decision making for who goes on warfarin is taken often by one person, monitoring of warfarin is taken by another person and in our practice people are monitored in different systems, alright and er . . . ongoing responsibility for patient education is nonexistent . . . the potential risks of warfarin to me are so large in terms of errors basically.” (Family physician, UK) [29].