Assessment of quality of life, satisfaction with anticoagulation therapy, and adherence to treatment in patients receiving long-course vitamin K antagonists or direct oral anticoagulants for venous thromboembolism

Figures & data

Figure 1 Flowchart.

Abbreviations: DOAC, direct oral anticoagulant; VKA, vitamin K antagonist; P-VKA, primary VKA for at least 3 months, and no prior DOAC; P-DOAC, primary DOAC for at least 3 months, and no prior VKA; S-DOAC, primary VKA switched to DOAC for at least 3 months.

Table 1 Population characteristics

Variable	DOAC (N=50)	VKA (N=50)	Total (N=100)	P-value*
Age (years): mean score (SD) [1st–3rd quartile]	57.4 (20.9) [42–76]	63.3 (15.7) [51–79]	60.4 (18.6) [46–78]	0.217
Gender female: N (%)	23 (46%)	23 (46%)	46 (46%)	1
Administrative area: N (%)				<0.001
75	32 (64%)	20 (40%)	52 (52%)
92	17 (34%)	7 (14%)	24 (24%)
93	0 (0%)	8 (16%)	8 (8%)
95	1 (2%)	15 (30%)	16 (16%)
Isolated DVT: N (%)	33 (66%)	31 (62%)	64 (64%)	0.677
Isolated PE: N (%)	10 (20%)	8 (16%)	18 (18%)	0.603
DVT + PE: N (%)	7 (14%)	11 (22%)	18 (18%)	0.298
History of cancer: N (%)	5 (10%)	3 (6%)	8 (8%)	–
History of hemorrhage#: N (%)	4 (8%)	8 (16%)	12 (12%)	–
Proximal VTE: N (%)	32 (64%)	22 (44%)	54 (54%)	–
Community physician: N (%)	4 (8%)	23 (46%)	27 (27%)	<0.001
Hospital follow-up: N (%)	47 (94%)	27 (54%)	74 (74%)	<0.001
Treatment duration >6 months: N (%)	35 (70%)	20 (40%)	55 (55%)	0.003
Treatment: N (%)				–
Xarelto	47 (94%)	0 (0%)	47 (47%)
Previscan	0 (0%)	26 (52%)	26 (26%)
Coumadin	0 (0%)	22 (44%)	22 (22%)
Other‡	3 (6%)	2 (4%)	5 (5%)
P-DOAC: N (%)	40 (80%)	–	40 (80%)	–
VTE evolution duration (months): N (%)	6.2 (4.7)	28.0 (39.1)	17.1 (29.8)	<0.001
Treatment duration (months): N (%)	6.1 (4.7)	27.6 (39.0)	16.8 (29.7)	<0.001

Notes:

* Wilcoxon test for continuous variables, Pearson’s χ² test for ordered categorical variables.

# VKA group: 5 with history of minor hemorrhage and 3 of major hemorrhage (upper digestive, cerebral, and articular). DOAC group: 2 with history of minor hemorrhage and 2 of major hemorrhage (digestive and postoperative parietal hematoma).

‡ Other treatments including Eliquis^®, Sintrom^®. Reason for switch from VKA to DOAC: 10 out of 50 patients (20%) switched from VKA to DOAC – by choice in 3 cases; other reasons comprised heavy biological monitoring for 3 patients, thrombophilia (protein S deficit, 2 patients; alopecia, 1 patient; INR fluctuation in psychiatric context, 1 patient).

Abbreviations: DOAC, direct oral anticoagulant; DVT, deep venous thrombosis; P-DOAC, DOAC with primary DOAC for at least 3 months and no prior VKA; PE, pulmonary embolism; SD, standard deviation; VKA, vitamin K antagonist; VTE, venous thromboembolism.

Figure 2 Quality of life scores (EQ-5D) in DOAC and VKA groups.

Abbreviations: DOAC, direct oral anticoagulant; F, female; M, male; VKA, vitamin K antagonist.

Table 2 Quality of life scores (EQ-5D)

Dimension	DOAC (N=50)	VKA (N=50)	P-value*
Mobility: N (%)			0.530
No problems	40 (80%)	38 (76%)
Moderate problems	10 (20%)	9 (18%)
Extreme problems	0 (0%)	3 (6%)
Self-care: N (%)			0.170
No problems	47 (94%)	43 (86%)
Moderate problems	3 (6%)	5 (10%)
Extreme problems	0 (0%)	2 (4%)
Usual activities: N (%)			0.096
No problems	44 (88%)	38 (76%)
Moderate problems	6 (12%)	9 (18%)
Extreme problems	0 (0%)	3 (6%)
Pain/discomfort: N (%)			0.011
No problems	32 (64%)	21 (42%)
Moderate problems	18 (36%)	24 (48%)
Extreme problems	0 (0%)	5 (10%)
Anxiety/depression: N (%)			0.920
No problems	37 (74%)	38 (76%)
Moderate problems	12 (24%)	9 (18%)
Extreme problems	1 (2%)	3 (6%)
VAS (0–100): mean score (SD)	71 (14)	65 (14)	0.063
[1st–3rd quartile]	[60–80]	[60–80]

Notes:

* Wilcoxon test for continuous variables, likelihood ratio test for proportional odds model for ordered categorical variables.

Abbreviations: SD, standard deviation; VAS, visual analog scale; DOAC, direct oral anticoagulant; VKA, vitamin K antagonist.

Figure 3 Scores on EQ-5D visual analog scale (EQ-VAS).

Abbreviations: DOAC, direct oral anticoagulant; VKA, vitamin K antagonist.

Figure 4 Scores on PACT-Q2 questionnaire.

Abbreviations: DOAC, direct oral anticoagulant; F, female; M, male; VKA, vitamin K antagonist; PACT-Q2, part 2 of the Perception of Anticoagulant Treatment Questionnaire.

Table 3 Treatment satisfaction scores (PACT-Q2)

Score*	DOAC (N=50)	VKA (N=50)	P-value#
Total	88.0 (4.4) [85–91]	81.5 (7.4) [78–88]	<0.001
Practical aspects	97.8 (5.3) [99–100]	92.8 (7.2) [90–99]	<0.001
Satisfaction	75.9 (8.5) [69–80]	71.3 (9.0) [66–77]	0.059
Adherence	75.4 (7.1) [70–80]	70.8 (12.3) [70–80]	0.063

Notes:

* Scores expressed as mean (standard deviation) [1st–3rd quartile].

# Wilcoxon test for continuous variables, likelihood ratio test for proportional odds model for ordered categorical variables.

Abbreviations: DOAC, direct oral anticoagulant; VKA, vitamin K antagonist; PACT-Q2, part 2 of the Perception of Anticoagulant Treatment Questionnaire.