Co-design of a patient education booklet on Direct Oral Anticoagulant medicines and elicitation of patient perspectives

Introduction: Direct Oral Anticoagulants (DOACs) are high-alert medications requiring structured patient education to mitigate safety risks and reduce preventable harm during Venous Thromboembolism (VTE) management. The National VTE Clinical Programme (NCP-VTE) in Ireland identified a critical need for a standardised patient medicines information resource that is tailored to the specific needs of VTE patients. Aim To co-design a patient education booklet on DOAC medicines and explore VTE patient perspectives on the booklet and DOAC medicines education. Method This study utilised an expert panel consensus methodology for booklet development, and artefact elicitation-based focus groups to explore patient perspectives and experiences. A multidisciplinary panel, including eight clinicians and a patient partner, devised the booklet content with iterative reviews conducted by clinical stakeholders. Subsequently, the developed booklet was used as an elicitation artefact for focus groups with VTE participants who are currently taking DOACs, to explore patient experiences and perceptions. Results The booklet contains essential patient safety information including risk-stratified side-effects and associated actions. Thematic analysis of focus group transcripts identified three major themes: the presence of complex and evolving medicines information needs subsequent to a clot event, a desire for practical, actionable medication management advice, and a nuanced view of medication risks that was characterised by active development of individual risk management practices. Conclusion Incorporating multidisciplinary expertise, external stakeholder review, and structured patient feedback enabled development of a patient education booklet that participants regarded as useful and accessible. Focus group participants described complex and evolving medicines information needs following VTE, emphasised the value of practical medication-management guidance, and outlined active approaches to managing medication-related risk. These findings suggest that patient education resources should support both medicines safety and broader recovery following VTE.