Please use this identifier to cite or link to this item: http://buratest.brunel.ac.uk/handle/2438/7145
Title: Factors determining patients’ intentions to use point-of-care testing medical devices for self-monitoring: The case of international normalised ratio self-testing
Authors: Shah, SGS
Barnett, J
Kuljis, J
Hone, K
Kaczmarski, R
Keywords: Oral anticoagulation;INR self-testing;Technology-acceptance model;Trust in doctor;Home testing;Affordability;Structural equation modeling
Issue Date: 2012
Publisher: Dove Medical Press Ltd
Citation: Patient Preference and Adherence, 2013(7): 1 - 14, Dec 2012
Abstract: Purpose: To identify factors that determine patients' intentions to use point-of-care medical devices, ie, portable coagulometer devices for self-testing of the international normalized ratio (INR) required for ongoing monitoring of blood-coagulation intensity among patients on long-term oral anticoagulation therapy with vitamin K antagonists, eg, warfarin. Methods: A cross-sectional study that applied the technology-acceptance model through a self-completed questionnaire, which was administered to a convenience sample of 125 outpatients attending outpatient anticoagulation services at a district general hospital in London, UK. Data were analyzed using descriptive statistics, factor analyses, and structural equation modeling. Results: The participants were mainly male (64%) and aged ≥ 71 years (60%). All these patients were attending the hospital outpatient anticoagulation clinic for INR testing; only two patients were currently using INR self-testing, 84% of patients had no knowledge about INR self-testing using a portable coagulometer device, and 96% of patients were never offered the option of the INR self-testing. A significant structural equation model explaining 79% of the variance in patients’ intentions to use INR self-testing was observed. The significant predictors that directly affected patients' intention to use INR self-testing were the perception of technology (β = 0.92, P < 0.001), trust in doctor (β = −0.24, P = 0.028), and affordability (β = 0.15, P = 0.016). In addition, the perception of technology was significantly affected by trust in doctor (β = 0.43, P = 0.002), age (β = −0.32, P < 0.001), and affordability (β = 0.23, P = 0.013); thereby, the intention to use INR self-testing was indirectly affected by trust in doctor (β = 0.40), age (β = −0.29), and affordability (β = 0.21) via the perception of technology. Conclusion: Patients’ intentions to use portable coagulometers for INR self-testing are affected by patients' perceptions about the INR testing device, the cost of device, trust in doctors/clinicians, and the age of the patient, which need to be considered prior to any intervention involving INR self-testing by patients. Manufacturers should focus on increasing the affordability of INR testing devices for patients’ self-testing and on the potential role of medical practitioners in supporting use of these medical devices as patients move from hospital to home testing.
Description: This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited. - Copyright @ 2012 Dove Medical Press Ltd
This article has been made available through the Brunel Open Access Publishing Fund.
URI: http://www.dovepress.com/article_11842.t14543570
http://bura.brunel.ac.uk/handle/2438/7145
DOI: http://dx.doi.org/10.2147/PPA.S38328
ISSN: 1177-889X
Appears in Collections:Community Health and Public Health
Computer Science
Brunel OA Publishing Fund
Dept of Computer Science Research Papers

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