Satisfaction with oral anticoagulants in patients with atrial fibrillation

Abstract

BackgroundAlthough, by itself, atrial fibrillation is associated with an impairment of quality of life antithrombotic therapy may play a role.ObjectiveTo evaluate the satisfaction with anticoagulant treatment in patients with nonvalvular atrial fibrillation who attended internal medicine departments in Spain.MethodsPatients from two different cross-sectional studies were combined. To measure the satisfaction with anticoagulant treatment, the Anti-Clot-Treatment Scale (ACTS) questionnaire was completed by every patient. A multivariate analysis was performed to determine the variables associated with satisfaction of patients receiving oral anticoagulants.ResultsA total of 1,309 patients (mean age 78.5±8.4 years; 49.3% men; CHA2DS2VASC 4.9±1.5; HAS-BLED 2.0±0.9) were included in the study, of whom 902 (68.9%) were taking vitamin K antagonists (VKA) and 407 (31.1%) direct oral anticoagulants (DOACs). Overall, satisfaction with oral anticoagulation was high (ACTS Burdens scale 49.69±9.45; ACTS Benefits scale 11.35±2.61). The perceived burdens with anticoagulant treatment were lower in men, as well as in patients with no dependency, normal renal function, who were not polymedicated, or who had moderate bleeding risk. Among patients taking VKA, those subjects with a lower number of International Normalized Ratio (INR) determinations in the last 6 months or with an optimal time in the therapeutic range exhibited a lower perceived burden. Patients taking DOACs (vs VKA) showed a lower perceived burden with anticoagulation. Benefits with anti-coagulation were higher in men, younger patients, those with no dependency, or low bleeding risk. Perceived benefits were higher in patients taking DOACs (vs VKA).ConclusionSatisfaction with oral anticoagulation was high in patients with nonvalvular atrial fibrillation, who were attending internal medicine departments daily in Spain. Among patients taking VKA, those subjects with a lower number of INR determinations in the last 6 months or with an optimal time in the therapeutic range exhibited a lower perceived burden with anticoagulant therapy. Patients taking DOACs (vs VKA) showed lower perceived burdens and higher perceived benefits with anticoagulation.

Time in therapeutic range, quality of life and treatment satisfaction of patients on long-term warfarin for non-valvular atrial fibrillation: a cross-sectional study

“…Similar finding was also observed in the Korean patients who received warfarin for NVAF when assessed by the Treatment Satisfaction Questionnaire for Medication (TSQM) [30]. A post-hoc study (ALADIN and ESPARTA) however reported significantly higher ACTS burden scale (better satisfaction) in NVAF patients with good TTR (≥ 50%) (p = 0.024) [19]. The cut-off point of good TTR in this study was lower than that commonly used (60-65%), therefore unable to make direct comparison with the current study.…”

“…Improving and enhancing satisfaction with the treatment regime is an important aspect in management of patients with chronic illness, such as AF [16]. Studies have shown a higher satisfaction, higher adherence, better knowledge and lower apprehension to warfarin therapy is associated with significantly better INR control [17][18][19].…”

Time in Therapeutic Range, Quality of Life and Treatment Satisfaction of Patients on Long-Term Warfarin for Non-Valvular Atrial Fibrillation: A Cross-Sectional Study

“…(30) A post-hoc study (ALADIN and ESPARTA) however reported signi cantly higher ACTS burden scale (better satisfaction) in NVAF patients with good TTR (≥ 50%) (p = 0.024). (19) The cut-off point of good TTR in this study was lower than that commonly used (60% -65%), therefore unable to make direct comparison with the current study.…”

“…(16) Studies have shown a higher satisfaction, higher adherence, better knowledge and lower apprehension to warfarin therapy is associated with signi cantly better INR control. (17)(18)(19) To date, studies that assess the TTR, HRQoL and treatment satisfaction of patients taking warfarin for NVAF concurrently are still limited. Therefore, this study aims to evaluate the TTR, HRQoL and treatment satisfaction of patients taking warfarin for NVAF in a tertiary cardiology referral center located in Sarawak, a state in Malaysia.…”

Anticoagulation Therapy by Age and Embolic Risk for Nonvalvular Atrial Fibrillation in Mexico, an Upper-Middle-Income Country: The CARMEN-AF Registry

“…In Mexico, OAT is less commonly prescribed for elderly patients, despite that age is a well-known risk factor for thromboembolism; this conduct may be related to the fear of hemorrhagic complications in this group of patients according to HAS-BLED score [13]. Elderly patients who did receive OAT were more likely to be prescribed with a DOAC instead of VKA, probably due to better adherence and ease of use of DOAC [14].…”