Pcv154 - Assessing Differential Attributes of Direct Oral Anticoagulants With Impact on Patient Preferences. A Pilot Study

Marzo, C; Cerezo-Manchado, Juan José; Curcio, Alejandro; García, M.A.; Gavín, Olga; Grandes, J.; Aristegui, R.; González, Marta Sánchez

doi:10.1016/j.jval.2018.09.699

Cited by 1 publication

(4 citation statements)

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“…In agreement with our results, bleeding-related risks are the main concerns for OAC users [ 21 , 23 – 25 , 27 ], placing administration characteristics as a secondary priority, by reinforcing that the clinical criteria is the prescription cornerstone. However, considering similar therapeutic options such as DOACs [ 16 , 17 ], posology and treatment administration characteristics became relevant decision-making drivers, easy to be considered in routine clinical practice and contributing to an optimal drug selection [ 21 , 29 ].…”

Section: Discussionsupporting

confidence: 89%

“…Main study variables were collected from patient’s medical history and from a study questionnaire ad-hoc designed, and validated by six clinical experts on anticoagulation management in Spain (supplementary materials) [ 25 ]. Importance, prevalence and satisfaction questions were based in 10-points scoring ranges.…”

Section: Methodsmentioning

confidence: 99%

“…Regarding caregivers, it was estimated that approximately 51% of DOAC- treated patients should have a caregiver [ 25 ], which makes a sample of 172 subjects sufficient to estimate preferences for a caregivers’ treatment option, with an accuracy of 7.5%.…”

Section: Methodsmentioning

confidence: 99%

“…In this regard, previous studies suggested that differential attributes of the available DOACs could be used as drivers for treatment decision-making, being potentially linked to patient profiles and preferences [ 21 , 25 ]. According to that, the main objective of our study was to identify patient (and caregiver) preferences and attributes importance regarding DOACs administration, as well as their potential link with patient/caregiver profiles.…”

Section: Introductionmentioning

confidence: 99%

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Treatment preferences as basis for decision making in patients using direct oral anticoagulants in Spain

Gavín

Grandes

García

et al. 2020

J Thromb Thrombolysis

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Treatment preferences are considered a relevant decision-making driver by the main atrial fibrillation (AF) guidelines. Direct Oral Anticoagulants (DOACs), considered as similar clinically, have administration differences useful for treatment individualization. Preferences, priorities and satisfaction of DOAC users were assessed through an observational, multicentric (25 hospitals), cross-sectional study including adult AF-patients (and/or caregivers) in Spain. Three study groups were considered according to DOAC posology preferences: (A) once-daily, with water; (B) once-daily, with food; (C) twice-daily. Overall, 332 patients and 55 caregivers were included. Mean (SD) age was 73.7 (10.7) years [58.7 (13.9) for caregivers]; 51.5% women [69.1% for caregivers]; 80.7% showed comorbidities and poly-pharmacy [6.6 (3.3) drugs/day]. No statistically significant differences were shown among study groups. Once-daily administration was preferred by 274 patients (82.5%) [60.8% (Group A); 21.7% (Group B); 17.5% (Group C)], and 47 caregivers (85.5%) [58.2% (Group A); 27.3% (Group B); 14.5% (Group C)]. Once-daily DOACs were prescribed in 42.8% of the patients. Bleeding risk was the main concern for both, patients and caregivers, followed by DOAC posology and interactions. Although treatment satisfaction (patients and caregivers) was high (9.0 and 9.1 points, respectively), match between individual treatment preferences and real prescriptions was only shown in 41.0% of AF-patients, evidencing a need for patient involvement on treatment decision-making. There is not a patient profile linked to treatment preferences, and clinical criteria must be the main driver for decision-making. However, for most AF-patients (elderly patients), aged, with comorbidity, poly-pharmacy and high cardiovascular risk, once-daily DOACs would be the preferred option.

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