Satisfaction With Oral Anticoagulants Among Patients With Atrial Fibrillation: A Prospective Observational Study

Salmasi, Shahrzad; Adelakun, Adenike; Safari, Abdollah; Kwan, Leanne; MacGillivray, Jenny; Andrade, Jason G.; Deyell, Marc W.; Loewen, Peter

doi:10.1016/j.cjco.2021.06.015

Cited by 5 publications

(3 citation statements)

References 38 publications

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“… 12 Our study found that 52.6% of patients were satisfied with the anticlot treatment, which is similar to the satisfaction level reported in Sudanese patients (50.5%), 27 but lower than the Saudi Arabian study's report (63.7%). 12 Regarding ACTS subscale scores, the mean ACTS burden score was lower than that reported in studies conducted in Canada, Japan, and Saudi Arabia 17 , 40 , 41 among patients receiving warfarin therapy. Conversely, a higher ACTS benefit score was reported in our study when compared with the same studies, but was consistent with the Saudi study (11.74 ± 2.43 vs 11.92 ± 2.4).…”

Section: Discussionmentioning

confidence: 65%

Knowledge, Adherence, and Satisfaction With Warfarin Therapy and Associated Factors Among Outpatients at University Teaching Hospital in Ethiopia

Tadesse,

Yadeta,

Chelkeba

et al. 2024

Clin Appl Thromb Hemost

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Anticoagulation management using warfarin is challenging in clinical practice. This study aimed to evaluate the knowledge, adherence, and satisfaction with warfarin therapy and associated factors among outpatients at the Tikur Anbessa Specialized Hospital (TASH) in Addis Ababa, Ethiopia. An interview-based cross-sectional study was conducted among 350 patients receiving warfarin therapy at cardiac and hematology clinics of TASH. Anticoagulation knowledge assessment (AKA) questionnaires assessed the patients’ warfarin knowledge. Adherence to warfarin was evaluated using the Morisky Green Levine Scale (MGLS), and patient satisfaction with warfarin therapy was assessed using the 17-item anticlot treatment scale (ACTS). Binary logistic regression was used to determine factors associated with the outcome variables, and p < .05 was used as the cut-off point to declare a significant association. The mean AKA score was 59.35 ± 13.04% (10.68 ± 2.34 correct answers), and 82 (23.4%) of participants achieved a passing score. Based on the MGLS, 192 (54.9%) study participants adhered well to warfarin. The mean level of satisfaction was 53.67 ± 8.56, with mean scores of 41.93 ± 7.80 and 11.74 ± 2.43 in the ACTS burden and benefit subscales, respectively. One hundred eighty-four (52.6%) patients were satisfied with warfarin therapy. The absence of hyperthyroidism was significantly associated with poor knowledge of warfarin therapy (adjusted odds ratio [AOR] = 4.28, 95% confidence interval [CI]: 1.01–18.22). Those living with family had a 56% lower chance of poor warfarin adherence (AOR: 0.44; 95% CI: 0.21–0.93) than those living alone. This study shows room for improvement in patient knowledge, adherence, and satisfaction with warfarin therapy.

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Section: Discussionmentioning

confidence: 65%

Knowledge, Adherence, and Satisfaction With Warfarin Therapy and Associated Factors Among Outpatients at University Teaching Hospital in Ethiopia

Tadesse,

Yadeta,

Chelkeba

et al. 2024

Clin Appl Thromb Hemost

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“…European Patient Survey in Atrial Fibrillation (EUPS-AF), conducted prior to the approval and widespread uptake of direct thrombin and factor Xa inhibitors, found high patients’ satisfaction with their care: 85.5% of patients rated the quality of care on a five-point Likert scale as good, very good, or excellent [ 49 ]. A recent study demonstrated mixed effects of atrial fibrillation treatment choice, with higher satisfaction in patients on direct oral anticoagulants in unadjusted analysis and higher satisfaction in patients on vitamin K antagonists in covariate-adjusted analysis [ 50 ]. In Lithuania, most patients with atrial fibrillation use warfarin; therefore, they have to visit a PHC centre for coagulation tests once a month.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Satisfaction with Healthcare Services in Multimorbid Patients Using PACIC+ Questionnaire: A Cross-Sectional Study

et al. 2023

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Background and Objectives: Although multimorbidity poses many challenges for both individuals and healthcare systems, information on how these patients assess the quality of their healthcare is lacking. This study assessed the multimorbid patients’ satisfaction with their healthcare. Materials and Methods: This cross-sectional study was a part of a project Joint Action—Chronic Diseases and Promoting Healthy Ageing across the Life Cycle and its implementation. The study included 400 patients with arterial hypertension and at least one concomitant chronic disease. Patients completed The Patient Assessment of Care for Chronic Conditions Plus (PACIC+) questionnaire, EuroQol Five-Dimensions—Three-Level Quality of Life questionnaire, and Hospital Anxiety and Depression scale. Results: The mean age of the participants was 65.38 years; there were 52.5% women. The mean PACIC+ 5As summary score was 3.60. With increasing age, participants rated worse on most PACIC+ subscales. Participants who assessed their quality of life as worse were also less satisfied with their healthcare. The presence of three or more concomitant diseases negatively affected PACIC+ scores. Patients with ischemic heart disease and heart failure had lower PACIC+ scores on most subscales, whereas patients with atrial fibrillation had lower scores only on the Agree subscale. The presence of diabetes was not associated with worse PACIC+ scores; moreover, the scores in Assist and Arrange subscales were even better in diabetic patients (3.36 vs. 2.80, p = 0.000 and 3.69 vs. 3.13, p = 0.008, respectively). Patients with chronic obstructive pulmonary disease, asthma, and musculoskeletal disorders showed lower PACIC+ scores. Conclusions: Older age, worse self-assessed health state, presence of three or more diseases, and certain chronic diseases were associated with lower patients’ satisfaction with their healthcare. Personalized healthcare, increasing competencies of primary healthcare teams, healthcare services accessibility, and financial motivation of healthcare providers may increase multimorbid patients’ satisfaction with their healthcare.

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“… 87 As well as requiring frequent monitoring and dose adjustments, to ensure appropriate INRs, VKAs also interact with other drugs and certain foods, which can increase bleeding risk and effectiveness, making for complicated therapeutic and dietary regimes for elderly patients, who are often taking many other medications. 88 , 89 These factors have been shown to be linked to reduced patient satisfaction with their OAC treatment 90 which in turn leads to inadequate adherence to VKAs and subsequently poorly anticoagulated patients. 91 In one study, adherence, defined as being greater than 80% was recorded in 51.2% of patients after one year of being prescribed VKAs, following an AF diagnosis.…”

Section: Oral Anticoagulantsmentioning

confidence: 99%

Pharmacy-Led Management of Atrial Fibrillation: Improving Treatment Adherence and Patient Outcomes

Veale

2024

IPRP

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The world’s population is ageing, with the number of those over 60 years expected to represent a fifth of the total population by 2050. Increases in chronic long-term health conditions (LTCs) associated with ageing, and requiring regular but often avoidable medical intervention, are pressurising already overloaded, health and social care systems. Atrial fibrillation (AF) is an LTC, which is most frequently diagnosed in the elderly. An often, asymptomatic condition, AF is associated with a 3- to 5-fold increased risk of severe ischemic stroke. Stroke prevention, with risk-stratified oral anticoagulants (OACs) is the standard recommended care for patients with AF. Stroke avoidance is, however, dependent on persistent adherence to OAC medication, with an adherence rate of >80% considered necessary to achieve optimal health outcomes. Suboptimal adherence to OACs is common, with a third of all AF patients not taking their medication as prescribed. This combined with the short half-life of OACs can result in poor clinical outcomes for patients. Policy makers now consider improving adherence to prescribed medicines for LTCs, a public health priority, to ensure better health outcomes for patients, whilst minimising unnecessary health system costs. Prescribing medicines to treat LTCs, such as AF, is not enough, particularly when the patient may not experience any measurable benefit to the treatment and may instead, experience medication-associated adverse events, including a risk of bleeding. Pharmacists who are experts in medicines management are ideally placed to support medication adherence, to educate, and to improve health outcomes for patients with AF. In this review, I will consider the evidence for poor medication adherence in LTCs and in particular adherence to OACs in patients with AF and highlight the role that pharmacists can play in ensuring optimal adherence and showcase pharmacist-led interventions that effectively address this problem.

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Satisfaction With Oral Anticoagulants Among Patients With Atrial Fibrillation: A Prospective Observational Study

Cited by 5 publications

References 38 publications

Knowledge, Adherence, and Satisfaction With Warfarin Therapy and Associated Factors Among Outpatients at University Teaching Hospital in Ethiopia

Knowledge, Adherence, and Satisfaction With Warfarin Therapy and Associated Factors Among Outpatients at University Teaching Hospital in Ethiopia

Evaluation of Satisfaction with Healthcare Services in Multimorbid Patients Using PACIC+ Questionnaire: A Cross-Sectional Study

Pharmacy-Led Management of Atrial Fibrillation: Improving Treatment Adherence and Patient Outcomes

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