Initiation of rivaroxaban in patients with nonvalvular atrial fibrillation at the primary care level:

Engelberger, Rolf P.; Noll, Georg; Schmidt, Dominique; Alatri, Adriano; Frei, Benedikt; Kaiser, Walter E.; Kucher, Nils

doi:10.1016/j.ejim.2015.04.014

Cited by 17 publications

(5 citation statements)

References 29 publications

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“…Improvement of patient satisfaction may also be related to the good safety profile. Our results are consistent with the Star study that shows AF patient satisfaction increases with rivaroxaban compared with VKA with a shorter follow-up and with a 6-response Likert rating scale [15]. …”

Section: Discussionsupporting

confidence: 92%

Patient-Reported Treatment Satisfaction with Rivaroxaban for Stroke Prevention in Atrial Fibrillation. A French Observational Study, the SAFARI Study

Hanon

Chaussade

Gueranger³

et al. 2016

PLoS ONE

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BackgroundFor antithrombotic treatments, Patient Reported Outcomes (PRO) and patient satisfaction with treatment are essential data for physicians because of the strong relationship between patient satisfaction and adherence to treatment. The impact of rivaroxaban on patient satisfaction and quality of life was not sufficiently documented in phase III studies. There is a need for further data in this field especially in real life conditions.MethodsThe SAFARI study is composed of patients with non-valvular atrial fibrillation (AF), previously treated with vitamin K antagonist (VKA) and switched to rivaroxaban. Patient satisfaction with anticoagulant therapy was measured by the Anti-Clot Treatment Scale (ACTS), a validated 15-item patient-reported scale including a 12-item ACTS Burdens scale and a 3-item ACTS Benefits scale. Satisfaction of medication was compared between baseline and 1, 3 and 6 months.ResultsStudy population was composed of 405 patients. Mean age was 74.8 (standard deviation = 9.0) years and 63.0% were male. Mean CHA2DS2-VASc score was 3.4 (1.5) and mean HAS-BLED score was 2.9 (1.0). After 3 months of treatment with rivaroxaban, patient satisfaction improved compared with VKA: mean ACTS burdens scores significantly increased by 8.3 (8.9) points (p<0.0001) and ACTS benefits scale by 0.4 (2.9) (p<0.001). Compared with baseline, the improvement in ACTS burdens and benefits became apparent at 1 month (46.5 vs. 53.6 p<0.001 and 10.4 vs. 10.7, p<0.05 respectively) and persisted at 6 months (46.5 vs. 54.76 p<0.001 and 10.4 vs. 10.8 p = 0.02 respectively). Rivaroxaban persistence was 88.7% at 6 months.ConclusionsSAFARI data support a good risk-benefit balance for rivaroxaban, with a good safety profile and encourage PRO design studies. The switch from VKA to rivaroxaban improved patient satisfaction at 1, 3 and 6 months after rivaroxaban initiation among patients with AF, particularly in reducing patient-reported anticoagulation burden.

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Section: Discussionsupporting

confidence: 92%

Patient-Reported Treatment Satisfaction with Rivaroxaban for Stroke Prevention in Atrial Fibrillation. A French Observational Study, the SAFARI Study

Hanon

Chaussade

Gueranger³

et al. 2016

PLoS ONE

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“…10,11 A few years ago, DOACs were introduced and have proven to be as effective as VKAs in preventing cardiac thromboembolism and stroke in AF patients, with lower bleeding risk. Though clinicians increasingly use DOACs in AF patients to prevent stroke and systemic embolisms, 12,13 all but two studies included very few DOAC users in their bleeding prediction models. The first of these studies, published in 2015, derived its ORBIT score based on patients on rivaroxaban in a large randomized trial (Rocket-AF) with strict inclusion and exclusion criteria and only patients who received a single DOAC.…”

Section: Introductionmentioning

confidence: 99%

Novel bleeding risk score for patients with atrial fibrillation on oral anticoagulants, including direct oral anticoagulants

Adam

Feller

Syrogiannouli

et al. 2021

Journal of Thrombosis and Haemostasis

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“… 140 Engelberger et al reported a significant increase in satisfaction 3 months after switches from VKA to DOAC compared with baseline, the level of which was similar to VKA-naïve DOAC users. 78 …”

Section: Resultsmentioning

confidence: 99%

Oral anticoagulant switching in patients with atrial fibrillation: a scoping review

et al. 2023

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IntroductionOral anticoagulants (OACs) prevent stroke in patients with atrial fibrillation (AF). Several factors may cause OAC switching.ObjectivesTo examine the phenomenon of OAC switching in patients with AF, including all available evidence; frequency and patterns of switch, clinical outcomes, adherence, patient-reported outcomes, reasons for switch, factors associated with switch and evidence gaps.DesignScoping review.Data sourcesMEDLINE, Embase and Web of Science, up to January 2022.ResultsOf the 116 included studies, 2/3 examined vitamin K antagonist (VKA) to direct-acting OAC (DOAC) switching. Overall, OAC switching was common and the definition of an OAC switch varied across. Switching from VKA to dabigatran was the most prevalent switch type, but VKA to apixaban has increased in recent years. Patients on DOAC switched more to warfarin than to other DOACs. OAC doses involved in the switches were hardly reported and patients were often censored after the first switch. Switching back to a previously taken OAC (frequently warfarin) occurred in 5%–21% of switchers.The risk of ischaemic stroke and gastrointestinal bleeding in VKA to DOAC switchers compared with non-switchers was conflicting, while there was no difference in the risk of other types of bleeding. The risk of ischaemic stroke in switchers from DOAC versus non-switchers was conflicting. Studies evaluating adherence found no significant changes in adherence after switching from VKA to DOAC, however, an increase in satisfaction with therapy were reported. Reasons for OAC switch, and factors associated with OAC switch were mostly risk factors for stroke and bleeding. Clinical outcomes, adherence and patient-reported outcomes were sparse for switches from DOACs.ConclusionsOAC switching is common in patients with AF and patients often switch back to an OAC they have previously been on. There are aspects of OAC switching that have received little study, especially in switches from DOACs.

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Initiation of rivaroxaban in patients with nonvalvular atrial fibrillation at the primary care level:

Cited by 17 publications

References 29 publications

Patient-Reported Treatment Satisfaction with Rivaroxaban for Stroke Prevention in Atrial Fibrillation. A French Observational Study, the SAFARI Study

Patient-Reported Treatment Satisfaction with Rivaroxaban for Stroke Prevention in Atrial Fibrillation. A French Observational Study, the SAFARI Study

Novel bleeding risk score for patients with atrial fibrillation on oral anticoagulants, including direct oral anticoagulants

Oral anticoagulant switching in patients with atrial fibrillation: a scoping review

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