TY - JOUR
T1 - Quality of life and patient satisfaction in patients with atrial fibrillation on stable vitamin K antagonist treatment or switched to a non-vitamin K antagonist oral anticoagulant during a 1-year follow-up
T2 - A PREFER in AF Registry substudy
AU - De Caterina, Raffaele
AU - Brüggenjürgen, Bernd
AU - Darius, Harald
AU - Köhler, Sabine
AU - Lucerna, Markus
AU - Pecen, Ladislav
AU - Renda, Giulia
AU - Schilling, Richard John
AU - Schliephacke, Tessa
AU - Zamorano, José Luis
AU - Le Heuzey, Jean Yves
AU - Kirchhof, Paulus
N1 - Publisher Copyright:
© 2017 Elsevier Masson SAS
PY - 2018/2
Y1 - 2018/2
N2 - Background: Non-vitamin K antagonist oral anticoagulants (NOACs) are being introduced for stroke prevention in non-valvular Atrial Fibrillation (AF), and promise to be accepted better than Vitamin K Antagonists (VKAs) by patients, improving their Quality of Life (QoL). Aim: To assess to what extent patient-related factors influence decisions to switch from a VKA to a NOAC. Methods: The PREFER in AF Registry collected data at baseline in 2012 — at the beginning of NOAC prescriptions — and at 1-year follow-up, in 6412 patients in seven Western European countries. QoL and patient satisfaction questionnaires (EQ-5D-5L and/or PACT-Q2) were completed in 3777 patients at both visits. Data were compared across categories of patients on stable treatment with a VKA (i.e. continuously over the previous 12 months) (n = 2102) or recently switched (within 12 months) from a VKA to a NOAC (n = 213) during a 1-year follow-up, allowing a snapshot of factors influencing the switch at a time when NOACs were being introduced into the market. Results: Compared to patients on stable treatment with a VKA, switched patients were similar in terms of age, sex, body mass index and other risk factors, but had lower prevalences of hypertension and heart valve dysfunction, and a lower rate of use of concomitant treatment with antiplatelet/anti-inflammatory agents; they also had a lower CHA2DS2-VASc score. Among 25 features investigated, switched patients more often reported bruising or bleeding, complained about bruising, were dissatisfied with the anticoagulant treatment, and reported mobility problems and anxiety/depressive traits. Conclusions: At the beginning of NOAC prescriptions, European doctors tended to switch from VKAs to NOACs those patients at lower risk than “non-switchers”. Complaints about bruising or bleeding, dissatisfaction with treatment, mobility problems and anxiety/depression traits appear to be related to — and may have influenced — the choice to switch from a VKA to a NOAC.
AB - Background: Non-vitamin K antagonist oral anticoagulants (NOACs) are being introduced for stroke prevention in non-valvular Atrial Fibrillation (AF), and promise to be accepted better than Vitamin K Antagonists (VKAs) by patients, improving their Quality of Life (QoL). Aim: To assess to what extent patient-related factors influence decisions to switch from a VKA to a NOAC. Methods: The PREFER in AF Registry collected data at baseline in 2012 — at the beginning of NOAC prescriptions — and at 1-year follow-up, in 6412 patients in seven Western European countries. QoL and patient satisfaction questionnaires (EQ-5D-5L and/or PACT-Q2) were completed in 3777 patients at both visits. Data were compared across categories of patients on stable treatment with a VKA (i.e. continuously over the previous 12 months) (n = 2102) or recently switched (within 12 months) from a VKA to a NOAC (n = 213) during a 1-year follow-up, allowing a snapshot of factors influencing the switch at a time when NOACs were being introduced into the market. Results: Compared to patients on stable treatment with a VKA, switched patients were similar in terms of age, sex, body mass index and other risk factors, but had lower prevalences of hypertension and heart valve dysfunction, and a lower rate of use of concomitant treatment with antiplatelet/anti-inflammatory agents; they also had a lower CHA2DS2-VASc score. Among 25 features investigated, switched patients more often reported bruising or bleeding, complained about bruising, were dissatisfied with the anticoagulant treatment, and reported mobility problems and anxiety/depressive traits. Conclusions: At the beginning of NOAC prescriptions, European doctors tended to switch from VKAs to NOACs those patients at lower risk than “non-switchers”. Complaints about bruising or bleeding, dissatisfaction with treatment, mobility problems and anxiety/depression traits appear to be related to — and may have influenced — the choice to switch from a VKA to a NOAC.
KW - Atrial fibrillation
KW - Non-vitamin K antagonist oral anticoagulants
KW - Patient satisfaction
KW - Quality of life
KW - Switching
KW - Vitamin K antagonists
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UR - http://www.scopus.com/inward/citedby.url?scp=85029575240&partnerID=8YFLogxK
U2 - 10.1016/j.acvd.2017.04.007
DO - 10.1016/j.acvd.2017.04.007
M3 - Article
C2 - 28942115
AN - SCOPUS:85029575240
SN - 1875-2136
VL - 111
SP - 74
EP - 84
JO - Archives of Cardiovascular Diseases
JF - Archives of Cardiovascular Diseases
IS - 2
ER -