New Oral Anticoagulants vs Vitamin K Antagonists: Benefits for Health-Related Quality of Life in Patients with Atrial Fibrillation

Alegret, Josep M.; Viñolas, Xavier; Arias, Miguel Á.; Martínez‐Rubio, Antoni; Rebollo, Pablo; Ràfols, Carles; Martínez‐Sande, Luis

doi:10.7150/ijms.8916

Cited by 30 publications

(38 citation statements)

References 17 publications

(13 reference statements)

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“…There have been researches where the re-sults have been almost the same as in this study. Both researches state that at baseline NOAC users score better results than warfarin users [14]. But in this research we have found statistically signifi cant difference in separate section.…”

Section: Discussioncontrasting

confidence: 57%

Atrial fibrillation, oral anticoagulants and health related quality of life

et al. 2018

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Fibrilace síní (FS) je porucha srdečního rytmu, která může ovlivnit kvalitu života v souvislosti se zdravím. Na kvalitu života v souvislosti se zdravím může působit i užívání perorálních antikoagulancií, jak z hlediska léčebného přínosu nebo komplikací, tak z hlediska jejich užívání jako takových, kdy ovlivňují způsob života daného pacienta, tedy nutnost pravidelných laboratorních vyšetření i různá omezení ve stravování. Cíl: Určit a zjistit, zda existuje statisticky významný rozdíl při srovnání kvality života v souvislosti se zdravím osob užívajících antagonisty vitaminu K, warfarin a nová perorální antikoagulancia (novel oral anticoagulant, NOAC) rivaroxaban a dabigatran ve srovnání s pacienty neužívajícími žádné perorální antikoagulancium. Materiály a metody: Výzkumný projekt s použitím průřezové analýzy byl proveden na Klinice kardiologie Fakultní nemocnice Pauls Stradins v litevské Rize v období od října 2016 do června 2017. Účast v tomto výzkumném projektu byla nabídnuta osobám s vysokým rizikem nevalvulární fi brilace síní. V případě souhlasu s účastí byl s pacientem proveden ústní pohovor s dotazy na osobní anamnézu, demografi cké údaje, výsledky laboratorních testů i výsledky echokardiografi ckého vyšetření, výsledky modifi kovaného dotazníku SF-36 a užívaný typ NOAC. Údaje byly ověřeny na základě informací osobní anamnézy účastníka výzkumu. Ke statistické analýze byl použit software SPSS. Výsledky: Do výzkumu bylo zařazeno celkem 218 pacientů (56,9 % žen a 43,1 % mužů průměrného věku 70,4 roku s průměrnou hodnotu skóre CHA 2 D 2-VASc 4,4. Warfarin užívalo 37,6 % pacientů, NOAC 33,0 %, žádná perorální antikoagulancia neužívalo 29,4 % účastníků výzkumu. Statisticky významný rozdíl byl zjištěn mezi průměrnými hodnotami dimenzí fyzického fungování při srovnání osob užívajících warfarin (průměr 95,85) nebo NOAC (průměr 124,57); p = 0,012. Statisticky významný rozdíl byl rovněž prokázán v dimenzi sociálního fungování při srovnání účastníků výzkumu užívajících warfarin (průměr 96,16) nebo NOAC (průměr 119,08); p = 0,026. Negativní korelace mezi věkem a fyzickým fungováním dosáhla nízké hodnoty (r = 0,23). Nebyla zjištěna žádná korelace mezi dobou od stanovení diagnózy fi brilace síní a výsledky. Závěr: Užívání NOAC koreluje s nejvyššími hodnotami skóre kvality života v souvislosti se zdravím; byl nalezen statisticky významný rozdíl oproti osobám užívajícím warfarin v dimenzi fyzického fungování (warfarin 95,85; NOAC 124,57; p = 0,012) i sociálního fungování (warfarin 95,16; NOAC 119,08; p = 0,026). Negativní korelace se skóre fyzického fungování dosáhla nízkých hodnot.

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Section: Discussioncontrasting

confidence: 57%

Atrial fibrillation, oral anticoagulants and health related quality of life

et al. 2018

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“…Most of the existing studies either compare the HRQoL of these patients versus those on DOAC, or in a longitudinal manner. Ng et al, (34) Benzimra et al, (35) Contreras et al, (36) and Alegret et al, (37) have reported no signi cant difference in the HRQoL of patients with NVAF receiving long-term warfarin versus DOAC in real-world scenario. On the other hand, Balci et al reported signi cant improvement in every domain of SF-12v2 (all p < 0.001), (38) while de Caterina et al reported signi cant improvement in severe mobility problem (p = 0.003), pain/discomfort (p = 0.035), and anxiety/depression (p < 0.001) of EuroQoL Instrument 5 levels (EQ-5D-5L) among NVAF patients after switching from warfarin to DOAC.…”

Section: Discussionmentioning

confidence: 98%

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

Malik

Chai

et al. 2020

Preprint

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Background: The use of warfarin in patients with non-valvular atrial fibrillation (NVAF) can be challenging. In this study, we evaluate the time in therapeutic range (TTR), health-related quality of life (HRQoL) and treatment satisfaction of patients on long-term warfarin for NVAF. The HRQoL and treatment satisfaction were compared based on the TTR.Methods: A cross-sectional study was conducted among patients on warfarin for NVAF who attended the anticoagulant clinic of a tertiary cardiology referral center in Sarawak from 1st June 2018 to 31st May 2019. Patients’ TTR was calculated by using Rosendaal technique, while their HRQoL and treatment satisfaction were assessed by using Short Form 12 Health Survey version 2 (SF12v2) and Duke Anticoagulant Satisfaction Scale (DASS), respectively. Results: A total of 300 patients were included, with mean TTR score of 47.0 ± 17.3%. The physical component summary (PCS) and mental component summary (MCS) score of SF-12v2 were 47.0 ± 9.0 and 53.5 ± 9.6, respectively. The total score for DASS was 55.2 ± 21.3, while the score for limitations (L), hassles and burdens (H&B) and positive psychological impacts (PPI) were 18.0 ± 10.0, 15.6 ± 9.1 and 21.6 ± 5.9, respectively.Seventy-three (24.3%) patients had good TTR (≥ 60%), with mean of 70.2 ± 8.7%; while 227 (75.5%) patients with poor TTR had significantly lower mean of 39.5 ± 11.9% (p = 0.006). There was no significant difference in the score of PCS (p = 0.150), MCS (p = 0.919) and each domain of SF-12v2 (p = 0.184 – 0.684) between good and poor TTR, except for social functioning (p = 0.019). The total DASS score was also not significantly different between group (p = 0.779). Similar non-significant difference was also reported in all the DASS sub dimensions (p = 0.502 – 0.699).Conclusions: Majority of the patients on long-term warfarin for NVAF in the current study have poor TTR. Their HRQoL and treatment satisfaction are independent of their TTR. Achieving a good TTR do not compromise the HRQoL and treatment satisfaction. Therefore, appropriate measures should be taken to optimise INR control, failing which direct oral anticoagulant therapy should be considered.

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“…Most of the existing studies either compare the HRQoL of these patients versus those on DOAC, or in a longitudinal manner. Ng et al, (30) Benzimra et al, (31) Contreras et al, (32) and Alegret et al, (33) have reported no signi cant difference in the HRQoL of patients with NVAF receiving long-term warfarin versus DOAC in real-world scenario. On the other hand, Balci et al reported signi cant improvement in every domain of SF-12v2 (all p < 0.001),(34) while de Caterina et al reported signi cant improvement in severe mobility problem (p = 0.003), pain/discomfort (p = 0.035), and anxiety/depression (p < 0.001) of EuroQoL Instrument 5 levels (EQ-5D-5L) among NVAF patients after switching from warfarin to DOAC.…”

Section: Treatment Satisfactionmentioning

confidence: 98%

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

Malik

Chai

et al. 2020

Preprint

View full text Add to dashboard Cite

Background:The use of warfarin in patients with non-valvular atrial fibrillation (NVAF) can be challenging. In this study, we evaluate the time in therapeutic range (TTR), health-related quality of life (HRQoL) and treatment satisfaction of patients on long-term warfarin for NVAF. The HRQoL and treatment satisfaction were compared based on the TTR.Methods:A cross-sectional study was conducted among patients on warfarin for NVAF who attended the anticoagulant clinic of a tertiary cardiology referral center in Sarawak from 1st June 2018 to 31st May 2019. Patients’ TTR was calculated by using Rosendaal technique, while their HRQoL and treatment satisfaction were assessed by using Short Form 12 Health Survey version 2 (SF12v2) and Duke Anticoagulant Satisfaction Scale (DASS), respectively. Results: A total of 300 patients were included, with mean TTR score of 47.0 ± 17.3%. The physical component summary (PCS) and mental component summary (MCS) score of SF-12v2 were 47.0 ± 9.0 and 53.5 ± 9.6, respectively. The total score for DASS was 55.2 ± 21.3, while the score for limitations (L), hassles and burdens (H&B) and positive psychological impacts (PPI) were 18.0 ± 10.0, 15.6 ± 9.1 and 21.6 ± 5.9, respectively. Seventy-three (24.3%) patients had good TTR (≥ 60%), with mean of 70.2 ± 8.7%; while 227 (75.5%) patients with poor TTR had significantly lower mean of 39.5 ± 11.9% (p = 0.006). There was no significant difference in the score of PCS (p = 0.150), MCS (p = 0.919) and each domain of SF-12v2 (p = 0.184 – 0.684) between good and poor TTR, except for social functioning (p = 0.019). The total DASS score was also not significantly different between group (p = 0.779). Similar non-significant difference was also reported in all the DASS sub dimensions (p = 0.502 – 0.699).Conclusions:Majority of the patients on long-term warfarin for NVAF in the current study have poor TTR. Their HRQoL and treatment satisfaction are independent of their TTR. Achieving a good TTR do not compromise the HRQoL and treatment satisfaction. Therefore, appropriate measures should be taken to optimise INR control, failing which direct oral anticoagulant therapy should be considered.

show abstract

New Oral Anticoagulants vs Vitamin K Antagonists: Benefits for Health-Related Quality of Life in Patients with Atrial Fibrillation

Cited by 30 publications

References 17 publications

Atrial fibrillation, oral anticoagulants and health related quality of life

Atrial fibrillation, oral anticoagulants and health related quality of life

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

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

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