Real-life experience of quality of life, treatment satisfaction, and adherence in patients receiving oral anticoagulants for atrial fibrillation

Figures & data

Figure 1 Flowchart showing patient disposition.

Abbreviations: DOAC, direct oral anticoagulant; P-DOAC, primary DOAC; P-VKA, primary VKA; S-DOAC, switch from VKA to DOAC; S-VKA. switch from DOAC to VKA; VKA, vitamin K antagonists.

Table 1 Patient characteristics

Characteristics	Patients (n)	P-VKA (n=89)	S-DOAC (n=50)	P-DOAC (n=52)	S-VKA (n=9)	All patients (N=200)	p-value
Age, years: mean (SD)	200	75.7 (10.1)	75.8 (10.6)	71.3 (8.3)	69.3 (12.3)	74.3 (10.1)	0.004
Gender male: %	200	52	62	65	67	59	0.36
CHADS2: mean (SD)	200	2.07 (1.22)	1.88 (1.10)	1.31 (0.83)	2.00 (1.12)	1.8 (1.13)	0.002
CHA2DS2-VASc: mean (SD)	200	3.4 (1.6)	3.2 (1.5)	2.4 (1.3)	2.8 (1.6)	3.1 (1.53)	0.001
HAS-BLED: mean (SD)	148	2.04 (0.96)	2.08 (1.10)	NT	1.78 (1.30)	2.03 (1.03)	0.69
Antiplatelet therapy: %	200	13	14	21	33	17	0.32
Oral anticoagulant prescriber is cardiologist: %	200	97	86	100	89	96	NT
Referent physician of follow-up is GP: %	200	55	24	15	0	34	NT
Actual OACT <1 year (%)		15	62	54	75	40	NT
Actual OACT >1 year (%)		85	38	46	25	60	NT
Global OACT (years): mean (SD)		6.7 (5.5)	2.0 (0.8)	1.8 (1.1)	0.8 (1.1)	4.0 (4.5)	0.15

Abbreviations: DOAC, direct oral anticoagulant; GP, general practitioner; NT, not tested; OACT, oral anticoagulant therapy; P-DOAC, primary DOAC; P-VKA, primary VKA; S-DOAC, switch from VKA to DOAC; S-VKA. switch from DOAC to VKA; VKA, vitamin K antagonists.

Table 2 EQ-5D-3L VAS scores by group

Dimension of the score	P-VKA (n=89)	S-DOAC (n=50)	P-DOAC (n=52)	Statistical test, p-value
Mobility
No problems	46%	56%	67%	Chi-2=6.1, p=0.47a
Moderate/extreme problems	54%	44%	33%
Self-care
No problems	82%	90%	88%	Chi-2=2.1, p=0.35a
Moderate/extreme problems	18%	10%	12%
Usual activities
No problems	69%	74%	75%	Chi-2=0.85, p=0.66a
Moderate/extreme problems	31%	26%	25%
Pain/discomfort
No problems	53%	40%	65%	Chi-2=6.7, p=0.036a
Moderate/extreme problems	47%	60%	35%
Anxiety/depression
No problems	42%	44%	56%	Chi-2=2.8, p=0.25a
Moderate/extreme problems	58%	56%	44%
VAS: mean score (SD)	65 (16)	69 (17)	65 (16)	F2,188=1.3, p=0.29b

Notes:

a Proportional odds likelihood ratio test;

b Kruskal–Wallis test.

Abbreviations: DOAC, direct oral anticoagulant; EQ-5D-3L, EuroQol 5-Dimensions 3-Levels; P-DOAC, primary DOAC; P-VKA, primary VKA; S-DOAC, switch from VKA to DOAC; VAS, visual analog scale; VKA, vitamin K antagonists.

Figure 2 Distribution of patients with any problem (moderate or extreme) over time, for each of the EQ-5D dimensions.

Abbreviations: DOAC, direct oral anticoagulant; EQ-5D, EuroQol 5-Dimensions; P-DOAC, primary DOAC; P-VKA, primary VKA; S-DOAC, switch from VKA to DOAC; VKA, vitamin K antagonists.

Figure 3 Convenience and satisfaction dimension scores.

Abbreviations: DOAC, direct oral anticoagulant; P-DOAC, primary DOAC; P-VKA, primary VKA; S-DOAC, switch from VKA to DOAC; VKA, vitamin K antagonists.

Table 3 PACT-Q2 scores by group

Dimension of the score	P-VKA N=89	S-DOAC N=50	P-DOAC N=52	Statistical testa, p-value
Convenience score: mean score (SD)	87 (13)	95 (6)	96 (5)	F2,188=22, p<0.001
Satisfaction score: mean score (SD)	62 (11)	74 (14)	70 (13)	F2,188=20, p<0.001
Total: mean score (SD)	83 (7)	90 (5)	89 (5)	F2,188=39, p<0.001

Note:

a Kruskal–Wallis test.

Abbreviations: DOAC, direct oral anticoagulant; PACT-Q2, Perception of AntiCoagulant Treatment Questionnaire 2; P-DOAC, primary DOAC; P-VKA, primary VKA; S-DOAC, switch from VKA to DOAC; VKA, vitamin K antagonists.

Figure 4 MMAS-8 French translation scores: distribution of patients according to adherence.

Note: The MMAS (8-item) content, names, and trademarks are protected by US copyright and trademark laws. Permission for use of the scale and its coding is required. A license agreement is available from Donald E. Morisky, ScD, ScM, MSPH, 14725 NE 20th St Bellevue, WA 98007, USA; [email protected].
Abbreviations: DOAC, direct oral anticoagulant; MMAS-8, Morisky Medication Adherence Scale; P-DOAC, primary DOAC; P-VKA, primary VKA; S-DOAC, switch from VKA to DOAC; VKA, vitamin K antagonists.

Figure 5 Real life experience of patients with atrial fibrillation on oral anticoagulants: quality of life, satisfaction, and adherence.

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