Health related quality of life of patients undergoing oral anticoagulation therapy

Corbi, Inaiara Scalçone Almeida; Dantas, Rosana Aparecida Spadoti; Pelegrino, Flávia Martinelli; Carvalho, Ariana Rodrigues da Silva

doi:10.1590/s0104-11692011000400003

Cited by 26 publications

(38 citation statements)

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“…Third, medical complications, medical treatments, and poststroke care (i.e., rehabilitation) may influence disability in long-term follow-up; for example, patients may report fatigue from b-blockers 28 or psychological impairments from being placed on anticoagulation. 29 A prior study found that infarct growth on early brain MRI predicts disability after MIS, suggesting that the index stroke may be the key predictor. 30,31 However, a recent analysis from the CHANCE trial found that recurrent stroke has a major role in determining HRQOL after TIA and MIS.…”

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confidence: 99%

Quality of life in patients with TIA and minor ischemic stroke

et al. 2015

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Objective: We investigated health-related quality of life (HRQOL) in patients with TIA and minor ischemic stroke (MIS) using Neuro-QOL, a validated, patient-reported outcome measurement system.Methods: Consecutive patients with TIA or MIS who had (1) modified Rankin Scale (mRS) score of 0 or 1 at baseline, (2) initial NIH Stroke Scale score of #5, (3) no acute reperfusion treatment, and (4) 3-month follow-up, were recruited. Recurrent stroke, disability by mRS and Barthel Index, and Neuro-QOL scores in 5 prespecified domains were prospectively recorded. We assessed the proportion of patients with impaired HRQOL, defined as T scores more than 0.5 SD worse than the general population average, and identified predictors of impaired HRQOL using logistic regression.Results: Among 332 patients who met study criteria (mean age 65.7 years, 52.4% male), 47 (14.2%) had recurrent stroke within 90 days and 41 (12.3%) were disabled (mRS .1 or Barthel Index ,95) at 3 months. Any HRQOL impairment was noted in 119 patients (35.8%). In multivariate analysis, age (adjusted odds ratio [OR] 1.02, 95% confidence interval [CI] 1.01-1.04), initial NIH Stroke Scale score (adjusted OR 1.39, 95% CI 1.17-1.64), recurrent stroke (adjusted OR 2.10, 95% CI 1.06-4.13), and proxy reporting (adjusted OR 3.94, 95% CI 1.54-10.10) were independent predictors of impaired HRQOL at 3 months.Conclusions: Impairment in HRQOL is common at 3 months after MIS and TIA. Predictors of impaired HRQOL include age, index stroke severity, and recurrent stroke. Future studies should include HRQOL measures in outcome assessment, as these may be more sensitive to mild deficits than traditional disability scales. Neurology ® 2015;85:1957-1963 GLOSSARY BI 5 Barthel Index; CI 5 confidence interval; DWI 5 diffusion-weighted imaging; HRQOL 5 health-related quality of life; MIS 5 minor ischemic stroke; mRS 5 modified Rankin Scale; NIHSS 5 NIH Stroke Scale; OR 5 odds ratio.Patients with TIA and minor ischemic stroke (MIS) account for the majority of stroke patients who present for emergency care in the United States.1 Mild symptoms on presentation is a common reason for exclusion from IV tissue plasminogen activator administration.2 Acute ischemic stroke leads to decreases in health-related quality of life (HRQOL), even among those who have no or minimal poststroke disability.3 Although the outcomes of most patients with minor symptoms, defined by a low NIH Stroke Scale (NIHSS) score, are favorable, approximately 25% of such patients become disabled. 2Stroke outcomes traditionally have utilized disability scales of functional status, which often fail to represent the full effect of disease and treatment. The modified Rankin Scale (mRS) and Barthel Index (BI) are the most frequently used tools to measure disability and handicap after stroke. 4 With National Institute of Neurological Disorders and Stroke funding to address these limitations, Neuro-QOL was developed as a clinically robust and validated patient-reported HRQOL assessment tool for adults and children wit...

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Quality of life in patients with TIA and minor ischemic stroke

et al. 2015

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“…The means of the domains of the SF-36 ranged from 54.8 (physical aspects) to 82 (social aspects). AF patients, the recent use of anticoagulation (<1 year), women and elderly subjects had a worse HRQoL evaluation (Table 2) [30]. [26] Almeida et al…”

Section: • • Quality Of Life Questionnaires For Patients Treated Withmentioning

confidence: 99%

“…However, it should be noted that these scores (CHADS 2 , CHA 2 DS 2 -VASc and HAS-BLED) were not designed to assess the impact of anticoagulant therapy on quality of life and should not be used for this purpose (Table 1). On the other hand, the Short Form (36) Health Survey (SF-36) is a survey that allows measurement of general health status and has also been used in this context in different studies (Table 1) [30,31]. However, specific scales have been developed to assess the impact of anticoagulation on quality of life.…”

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confidence: 99%

Atrial Fibrillation and Quality of Life Related to Disease and Treatment: Focus On Anticoagulation

2014

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Anticoagulation therapy is essential to reduce the risk of stroke in patients with atrial fibrillation. Traditionally, clinical trials have focused only on determining the efficacy and safety of anticoagulation but not on quality of life. In the last few years there has been a growing interest in determining the quality of life of patients treated with oral anticoagulation. In fact, specific tools that can evaluate quality of life related to atrial fibrillation and anticoagulation have been developed. Vitamin K antagonists have been shown to be effective in the prevention of thromboembolic complications. However, the use of vitamin K antagonists implies changes in behavior and lifestyle modifications that may have a negative impact on the quality of life. It has been suggested that self-monitoring of international normalized ratio could improve this impact. On the other hand, as new oral anticoagulants overcome these limitations, they may improve quality of life related with anticoagulant therapy. Unfortunately, although encouraging, the clinical experience with them is still quite limited.

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“…2 No Brasil foram publicados estudos que abordam o tema qualidade de vida em pacientes anticoagulados, mas não específicos com usuários de varfarina, ou ainda, diferiram os instrumento para avaliar a qualidade de vida, não usando apenas o Duke Anticoagulation Satisfaction Scale (DASS), especifico para esta população. [3][4][5][6] Há também estudos internacionais sobre este tema, contudo mostram diferentes abordagens no que se refere ao uso de ACO, quando comparada com a atenção básica brasileira. 2,7 Sendo assim, esse estudo diferencia-se por estar aninhado a uma coorte de usuários de varfarina do sistema público de saúde que não possuem acompanhamento de equipe multiprofissional especializada em ACO.…”

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Qualidade de vida de usuários do sistema público de saúde em uso de varfarina

Dalpiaz

Colet

Petri

et al. 2017

Rev Epidemiol Control Infect

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Exceto onde especificado diferentemente, a matéria publicada neste periódico é licenciada sob forma de uma licença Creative Commons -Atribuição 4. Background and Objectives:Warfarin is an oral anticoagulant agent and users requires care that can interfere with quality of life. This study aims to assess the quality of life of warfarin users from the public health system according to the tool "Duke Anticoagulation Satisfaction Scale" (DASS). Methods: A cross-sectional study with users of the community public health system of both genders, aged over 18 years, residents of the municipality of Ijuí / RS, who received the warfarin from the public drug dispensing units of this municipality and had the cognitive capacity to answer the tool. Data collection was performed between January and February of 2015. The DASS tool was used to evaluate quality of life, of which results are quantitative, in which lower values indicate better satisfaction with the use of anticoagulant, less limitation, lower task/overload and lower psycho-logical impact, i.e., better quality of life. Answers to questions used for the evaluation of socio-demographic, clinical aspects and time of warfarin use were also collected. Results: We inter-viewed 49 users, 53.06% males, with a mean age of 63.16 ± 13.18 years. In the overall DASS domain, the result was 71.85 ± 18.48. No statistical differences were found regarding quality of life with sociodemographic and clinical characteristics. Significance was only observed regarding the time of anticoagulant use, as patients who had been using it for a longer time had a worse quality of life. Conclusion: It was observed that the users of the present study had a low quality of life, requiring the development of strategies to assist them.

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Health related quality of life of patients undergoing oral anticoagulation therapy

Cited by 26 publications

References 20 publications

Quality of life in patients with TIA and minor ischemic stroke

Quality of life in patients with TIA and minor ischemic stroke

Atrial Fibrillation and Quality of Life Related to Disease and Treatment: Focus On Anticoagulation

Qualidade de vida de usuários do sistema público de saúde em uso de varfarina

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