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Patient Prefer Adherence. 2018 Feb 19;12:267-274. doi: 10.2147/PPA.S152109. eCollection 2018.

Satisfaction with oral anticoagulants in patients with atrial fibrillation.

Author information

1
Internal Medicine Service, Hospital Universitario de La Princesa, Madrid.
2
Internal Medicine Department, Hospital Virgen Macarena, Seville.
3
Internal Medicine Service, Hospital San Cecilio, Granada.
4
Internal Medicine Service, Hospital Vall D Hebron, Barcelona.
5
Internal Medicine Service, Complejo Hospitalario Universitario Insular Materno-Infantil, Las Palmas de Gran Canaria.
6
Internal Medicine Service, Hospital General De Valencia, Valencia.
7
Internal Medicine Service, Complejo Universitario Hospitalario de A Coruña, La Coruña.
8
Internal Medicine Service, Hospital Marqués de Valdecilla, Universidad de Cantabria, Santander.
9
Internal Medicine Service, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela.
10
Internal Medicine Service, Instituto Maimónides de Investigación Biomédica de Córdoba (IMIBIC), Hospital Reina Sofía, Universidad de Córdoba, Córdoba.
11
Neurology Service, Hospital del Mar, Barcelona.
12
Neurology Service, Complejo Hospitalario de Navarra, Pamplona, Navarra.
13
Neurology Service, Hospital Universitario de La Princesa, Instituto de Investigación Sanitaria La Princesa, Madrid.
14
Internal Medicine Service, Hospital Carlos III, Madrid, Spain.

Abstract

Background:

Although, by itself, atrial fibrillation is associated with an impairment of quality of life antithrombotic therapy may play a role.

Objective:

To evaluate the satisfaction with anticoagulant treatment in patients with nonvalvular atrial fibrillation who attended internal medicine departments in Spain.

Methods:

Patients 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.

Results:

A 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).

Conclusion:

Satisfaction 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.

KEYWORDS:

atrial fibrillation; benefit; burdens; direct oral anticoagulants; satisfaction; vitamin K antagonists

Conflict of interest statement

Disclosure The authors report no conflicts of interest in this work.

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