Christine,
Excellent start to closing this gap. I am wondering if you have any knowledge about secular trends in OACs since the introduction of the N-OACs as compared to warfarin. Also, you've chosen to emphasize the provider as the point of intervention, but is there any role that patient preference plays in the under-prescribing of OACs, particularly with warfarin, which requires arduous monitoring and lifestyle changes to maintain safety.
In terms of the stated construct in your analysis, however, I'm wondering if there are other cases, for pharmaceutical interventions, that you could follow in order to attempt to understand the provider barriers. It seems at this point there is a lot of clear benefits to the intervention (as evidenced by your gap analysis), but conjecture as to why this gap exists on the provider level. For instance, the use of beta-blockers that was cited in the first lecture may provide clues as to how the uptake of this intervention increased: controlled by specialists instead of primary care providers; a clear time point (MI/stroke) around which to intervene v the use of a preventive intervention; widely promulgated guidelines (ie by the well-funded AHA).
Looking forward to discussing in class!!
-Asa