Real-world evaluation of perception, convenience and anticoagulant treatment satisfaction of patients with atrial fibrillation switched from long-term vitamin K antagonist treatment to dabigatran

Choi, Eue Keun; Lee, Young Soo; Chern, Alan Koay Choon; Jiampo, P.; Chutinet, Aurauma; Hanafy, Dicky Armein; Trivedi, Prabhav; Zhai, Dongmei; Oh, Yong Seog

doi:10.1136/openhrt-2020-001343

Cited by 6 publications

(4 citation statements)

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“…It may be that in the PREFER in AF registry substudy, complaints about bruising/bleeding, treatment dissatisfaction and anxiety/depression may have influenced the switching from VKAs to NOACs. Multiple studies published subsequently have consistently observed that the NOACs, in comparison with the VKAs, have higher treatment satisfaction, convenience and perceived benefits, and lower perceived disease and treatment burdens in patients suffering from NVAF18 19 24 30–32 and also from other conditions where the NOACs are indicated 33 34. Consistent with recent studies, our study also shows higher treatment convenience and satisfaction scores with dabigatran compared with VKAs and adds to a growing wealth of data.…”

Section: Discussionsupporting

confidence: 90%

“…17 Higher scores in PACT-Q2 indicate better convenience and higher treatment satisfaction 16. Two recent studies, one conducted in Europe and Israel and the other in South East Asia and South Korea, showed significant improvements in treatment convenience and satisfaction scores in patients who switched from a VKA to dabigatran for stroke prevention 18 19. In this study, PACT Q2 was used to evaluate patient perception of anticoagulation with dabigatran versus VKAs when used for stroke prevention in patients with newly diagnosed AF in South East Asia and South Korea.…”

Section: Introductionmentioning

confidence: 99%

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Patient perception and treatment convenience of dabigatran versus vitamin K antagonist when used for stroke prophylaxis in atrial fibrillation: Real-world Evaluation of Long-term Anticoagulant Treatment Experience (RE-LATE) study

Lee

Choi

et al. 2021

Open Heart

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PurposeDabigatran is a direct thrombin inhibitor approved for stroke prophylaxis in patients with non-valvular atrial fibrillation (NVAF). Real-world data about patient preference, satisfaction and convenience in patients in Asia are not available. The study aimed to explore the perception of patients with newly diagnosed NVAF regarding dabigatran versus vitamin K antagonists (VKAs), when used for stroke prevention.Patients and methodsThis was a multinational, multicentre, non-interventional study involving 49 sites across 5 countries in South East Asia and South Korea where 934 patients newly diagnosed with NVAF were initiated on either dabigatran (N=591) or VKA (N=343). Data were collected at baseline and over two follow-up visits across 6 months. Treatment satisfaction and patient convenience were evaluated using the Perception on Anticoagulant Treatment Questionnaire-2 (PACT-Q2).ResultsThe mean age of the patients was 65.9±10.4 years, and 64.2% were male. Mean CHA2DS2-VASc score was 2.4±1.5, and mean HAS-BLED score was 1.2±0.9. At baseline, patients initiated on dabigatran had higher stroke risk, bleeding risk, creatinine clearance and proportion of patients with concomitant illnesses compared with patients initiated on VKAs. Treatment convenience was perceived to be significantly better with dabigatran versus VKAs at visits 2 and 3 (p=0.0423 and 0.0287, respectively). Treatment satisfaction was significantly better with dabigatran compared with VKAs at visit 3 (p=0.0300).ConclusionIn this study, dabigatran is associated with better patient perception in terms of treatment convenience and satisfaction compared with VKAs when used for stroke prevention in newly diagnosed NVAF patients from South East Asia and South Korea.Trial registration numberNCT02849509.Plain language summaryPatient satisfaction with dabigatran versus VKAs in South East Asia. Patients with atrial fibrillation are at high risk of stroke and require anticoagulants for stroke prevention. Two such anticoagulants are dabigatran and VKAs. We wanted to compare the extent of satisfaction and treatment convenience among newly diagnosed patients with atrial fibrillation from the South East Asian region when they were given either dabigatran or VKAs. Consenting patients filled out a standardised questionnaire called the PACT-Q2 over three visits after they were started on either dabigatran (591 patients) or VKAs (343 patients). We found that satisfaction and convenience were significantly higher when patients received dabigatran than when they received VKAs.

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Section: Discussionsupporting

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Patient perception and treatment convenience of dabigatran versus vitamin K antagonist when used for stroke prophylaxis in atrial fibrillation: Real-world Evaluation of Long-term Anticoagulant Treatment Experience (RE-LATE) study

Lee

Choi

et al. 2021

Open Heart

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“…Reasons for high levels of compliance with DOACs likely include ease of use, including no requirement to monitor DOAC levels except for special cases such as in patients with particularly high or low body weight. 30–33 The advantage of lack of necessity to monitor anticoagulation with DOACs may improve patients' access to treatment (eg, for those in remote rural areas). DOAC plasma levels also decrease quickly, 33 allowing more straightforward surgical interventions.…”

Section: Discussionmentioning

confidence: 99%

Antithrombotic Usage, Including Three-Year Outcomes With Dabigatran and Vitamin K Antagonists for Atrial Fibrillation, in Eastern Europe: A Descriptive Analysis From Phase 3 of the GLORIA-AF Registry

Bergler-Klein,

Gotcheva,

Kalējs

et al. 2023

American Journal of Therapeutics

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Background: Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF) is a prospective registry of outcomes from patients with newly diagnosed AF at risk of stroke. In the propensity score (PS)-matched global population of phase 3 GLORIA-AF, at 3 years, dabigatran-treated patients experienced reduced risk for major bleeding, and similar risk for stroke and myocardial infarction, compared with vitamin K antagonist (VKA)-treated patients. Study Question: Do patients in Eastern Europe benefit from treatment with dabigatran versus VKA? Study Design: Descriptive analysis, without PS matching. To contextualize the Eastern Europe results of GLORIA-AF phase 3, we also descriptively analyzed the global population without PS matching. Consecutive patients with newly diagnosed AF and CHA2DS2-VASc-score ≥1 were enrolled until December 2016 in 38 countries (9 in Eastern Europe). Measures and Outcomes: Three-year outcomes with dabigatran and VKA. Results: In Eastern Europe, 1341 patients were eligible (6% of patients globally), and incidence rates (per 100 patient-years) for the following outcomes were numerically lower with dabigatran (N = 498) versus VKA (N = 466): major bleeding (0.26 vs. 0.90), all-cause death (2.04 vs. 3.50), and a composite of stroke, systemic embolism, myocardial infarction, life-threatening bleeding, and vascular death (1.37 vs. 1.92); stroke was comparable (0.51 vs. 0.50). All incidence rates were numerically lower in Eastern Europe versus the global population for both treatments. Chronic concomitant use of high bleeding risk medications (eg, nonsteroidal anti-inflammatories) was lower in Eastern Europe (dabigatran 3.8%, VKA 9.3%) than globally (dabigatran 14.8%, VKA 20.6%) and persistence with dabigatran was higher in Eastern Europe (76%) than globally (64%). Conclusions: Dabigatran was associated with numerically reduced major bleeding, all-cause death, and cardiovascular (CV) composite, with comparable risk of stroke versus VKA, in Eastern Europe. Limitations of this descriptive analysis include few CV events (n = 11 for stroke, in the dabigatran and VKA groups combined) and a lack of statistical analysis and PS matching, which precludes definitive conclusions; however, the CV outcomes in Eastern Europe were consistent with the beneficial impact of dabigatran versus VKA in the statistically analyzed global population with PS matching.

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“…Patients' preferences are critical in determining adherence to OAC. In a recent study from Asia, the substitution of VKA therapy with dabigatran was associated with a significant improvement in treatment convenience and satisfaction [95], suggesting that NOACs are favored by AF patients themselves. Patients' sociodemographic characteristics and physicians' level of experience with VKAs vs. NOACs are other factors that could be relevant in choosing the type of OAC [18].…”

Section: Additional Evidence That May Reinforce the Choice Of Using Non-vitamin K Antagonists Instead Of Vitamin K Antagonistsmentioning

confidence: 99%

Many Good Reasons to Switch from Vitamin K Antagonists to Non-Vitamin K Antagonists in Patients with Non-Valvular Atrial Fibrillation

Botto¹,

Ameri

Caterina

2021

JCM

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Non-vitamin K oral anticoagulants (NOACs) are the first choice for prophylaxis of cardioembolism in patients with non-valvular atrial fibrillation (AF) who are anticoagulant-naïve, as well as the preferable anticoagulation strategy in those who are on vitamin K antagonists (VKAs), but with a low time in therapeutic range (TTR). Nonetheless, there are many good reasons to consider switching from VKAs to NOACs also when TTR is >70%. From the pharmacological standpoint, anticoagulation with VKAs may remain erratic even in those patients who have high TTR values, owing to the mode of action of this drug class. Furthermore, experimental data suggest that, unlike VKAs, NOACs favorably modulate the effects of factor Xa and thrombin in the cardiovascular system through the protease-activated receptor family. Clinically, the most striking advantage provided by NOACs over VKAs, irrespective of the TTR, is the substantially lower risk of intracranial hemorrhage. NOACs have also been associated with less deterioration of renal function as compared with VKAs and may confer protection against cardiovascular events not strictly related to AF, especially the acute complications of peripheral artery disease. In this narrative review, we discuss the evidence according to which it is warranted to systematically substitute NOACs for VKAs for the prevention of AF-related stroke and systemic embolism.

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Real-world evaluation of perception, convenience and anticoagulant treatment satisfaction of patients with atrial fibrillation switched from long-term vitamin K antagonist treatment to dabigatran

Cited by 6 publications

References 33 publications

Patient perception and treatment convenience of dabigatran versus vitamin K antagonist when used for stroke prophylaxis in atrial fibrillation: Real-world Evaluation of Long-term Anticoagulant Treatment Experience (RE-LATE) study

Patient perception and treatment convenience of dabigatran versus vitamin K antagonist when used for stroke prophylaxis in atrial fibrillation: Real-world Evaluation of Long-term Anticoagulant Treatment Experience (RE-LATE) study

Antithrombotic Usage, Including Three-Year Outcomes With Dabigatran and Vitamin K Antagonists for Atrial Fibrillation, in Eastern Europe: A Descriptive Analysis From Phase 3 of the GLORIA-AF Registry

Many Good Reasons to Switch from Vitamin K Antagonists to Non-Vitamin K Antagonists in Patients with Non-Valvular Atrial Fibrillation

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