Survey of the use of warfarin and the newer anticoagulant dabigatran in patients with atrial fibrillation

Figures & data

Figure 1 Dyspepsia questionnaire.

Table 1 Patient demographics

	Warfarin users (n=204)		Dabigatran users (n=160)		P-value
	%	n	%	n
Sex
Male	73a	149	63a	101	0.043
Health insurance
Yes	96	195	98	156	0.329
Education
High school graduate or equivalent (eg, GED)	16	32	13	21	0.028
College graduate (eg, BA, AB, BS)	20	41	23	37
Completed graduate school (eg, MS, MD, PhD)	16	33	23	37
Declined to answer	0a	0	0.6a	1
Ethnicity
African American	3	7	4	6	0.167
American Indian	1a	2	0a	0
Asian	3a	5	0a	0
Hispanic	2	4	4	6
White	91	186	91	146
Multiethnic	0a	0	0.6a	1
Declined to answer	0a	0	0.6a	1
Marital status
Married	66	135	68	108	0.481
Single, never married	5	11	8	12
Divorced	12	25	11	17
Separated	0.5	1	3	4
Widowed	13	26	10	16
Living with partner	3	6	2	3
BMI level
Under 18.5					<0.001
18.5 to <25	13	27	16	26
25 to <30	30a	61	49a	78
≥30	53a	109	32a	51
Declined to answer	3	6	3	5
CCI
0	37a	76	48a	77	0.037
1 or more	63a	128	52a	83
	Mean	SD	Mean	SD	P-value
Age, years	68	9.12	69	12	<0.001
Years diagnosed with AF	8	8.79	6	7.58	0.008
Number of pills taken daily	7	3.39	5	3.59	<0.001
1	5	2.59	3	2.50	<0.001
2	2	1.70	2	1.70	0.355
3	0.21	0.66	0.19	0.74	0.743
≥4	0.17	1.00	0.06	0.32	0.120
As needed	0.22	0.64	0.19	0.58	0.670

Note:

a Values are significantly different at P<0.05 in the two-sided test of equality for column proportions and equality of means.

Abbreviations: AF, atrial fibrillation; BMI, body mass index; CCI, Charlson Comorbidity Index; SD, standard deviation; GED, General Educational Development; BA, Bachelor of Arts; AB, Artium Baccalaureus; BS, Bachelor of Science; MS, Master of Science; MD, Doctor of Medicine; PhD, Doctor of Philosophy.

Figure 2 Analysis group definitions.

Table 2 Incidence and frequency of symptoms

	WUs (n=204)		NAUs (n=160)		P-value
	%	n	%	n
Experienced heart palpitations
No	57a	117	31a	50	<0.0001
Yes	43a	87	69a	110
Experienced irregular heartbeat
No	41a	84	30a	48	0.028
Yes	59a	120	70a	112
Experienced lack of energy
No	27	54	21	33	0.194
Yes	74	150	79	127
Experienced dizziness
No	51a	104	34a	55	0.002
Yes	49a	100	66a	105
Experienced chest discomfort
No	72a	147	52a	83	<0.0001
Yes	28a	57	48a	77
Experienced shortness of breath
No	41	83	36	57	0.325
Yes	59	121	64	103
Overall frequency of indigestion
Not at all	78a	159	44a	70	<0.0001
Less than once a month	10a	21	21a	34
Between once a month and once a week	7a	15	18a	28
Between once a week and once a day	3a	5	14a	23
Once a day or more	2	4	3	5
Overall frequency of heartburn
Not at all	74a	151	45a	72
Less than once a month	14	29	16	26
Between once a month and once a week	6a	13	17a	27
Between once a week and once a day	4a	9	13a	20
Once a day or more	1a	2	9a	15
Overall frequency of regurgitation
Not at all	76a	155	56a	89	<0.0001
Less than once a month	18	36	21	33
Between once a month and once a week	4a	8	13a	21
Between once a week and once a day	2a	3	8a	13
Once a day or more	1	2	3	4
Overall frequency of nausea
Not at all	86a	176	54a	87	<0.0001
Less than once a month	7a	15	19a	30
Between once a month and once a week	3a	7	16a	26
Between once a week and once a day	2a	3	9a	14
Once a day or more	2	3	2	3
Overall frequency of stomach pain
Not at all	79a	162	49a	78	<0.0001
Less than once a month	12a	24	22a	35
Between once a month and once a week	6a	12	21a	33
Between once a week and once a day	0.5a	1	6a	10
Once a day or more	3	5	3	4

Note:

a Values are significantly different at P<0.05 in the two-sided test of equality for column proportions and equality of means.

Abbreviations: WUs, warfarin users; NAUs, newer anticoagulant users.

Figure 3 (A) Gastrointestinal bleeding in the 3 months before the survey, (B) severity of gastrointestinal bleeding, (C) frequency of gastrointestinal bleeding, (D) duration of gastrointestinal bleeding, and (E) use of treatments for stomach-related symptoms.

Abbreviations: WU, warfarin users; NAU, newer anticoagulant users; OTC, over the counter.

Table 3 Medication characteristics and adherence

	Warfarin users (n=204)		Dabigatran users (n=160)		P-value
	Mean	SD	Mean	SD
Doses missed	0.63	1.78	0.65	1.78	0.916
Doses taken less than the prescribed amount	0.23	1.36	0.19	0.62	0.784
	%	n	%	n
Frequency of medication use per day
Once	94a	192	28a	44	<0.0001
≥Twice	6a	12	73a	116
I wanted to avoid the side effects of the medication
No	100a	33	98a	42	0.378
Yes	0.0a	0	2a	1
I forgot to take my medication
No	24	8	33	14	0.428
Yes	76	25	67	29
I didn’t think my medication was working
No	100	33	100	43	N/A
I had a change in routine
No	94a	31	65a	28	0.003
Yes	6a	2	35a	15
I fell asleep
No	91	30	79	34	0.161
Yes	9	3	21	9
I was too busy
No	91	30	84	36	0.358
Yes	9	3	16	7
It was recommended by my physician
No	88a	29	100a	43	0.019
Yes	12a	4	0a	0
I had a difficult time paying for the medication
No	100	33	100	43	N/A
I ran out of medication
No	97	32	93	40	0.445
Yes	3	1	7	3
I was concerned about interactions with alcohol
No	97a	32	100a	43	0.251
Yes	3a	1	0a	0
I was already taking too many medications
No	100a	33	98a	42	0.378
Yes	0a	0	2a	1
I was concerned about the risk of bleeding due to an activity I was going to do
No	91a	30	100a	43	0.044
Yes	9a	3	0a	0
I was bothered by stomach-related (gastrointestinal) side effects
No	100a	33	98a	42	0.378
Yes	0a	0	2a	1
I was bothered by side effects that were not stomach-related
No	97a	32	100a	43	0.251
Yes	3a	1	0a	0
Other reasons for nonadherence
No	88	29	93	40	0.442
Yes	12	4	7	3

Note:

a Values are significantly different at P<0.05 in the two-sided test of equality for column proportions and equality of means.

Abbreviations: N/A, not applicable; SD, standard deviation.

Table 4 Treatment decisions and switching medication

	WUs (n=204)		NAUs (n=160)		P-value
	%	n	%	n
Reason for using the current treatment
I made the decision myself then brought it up to my doctor	0a	0	2a	3	0.018
A friend or family member told me to bring it up with my doctor	0.5a	1	0a	0
My doctor told me I needed to start taking an oral anticoagulant	74a	150	61a	97
My doctor and I discussed it, then we both agreed	25a	50	37a	59
I should start taking an oral anticoagulant
I don’t remember	2	3	0.6	1
Have you considered switching your treatment?
Yes, I have seriously considered it	9a	13	3a	5	<0.001
Yes, I have somewhat considered it	23a	32	7a	11
No, I have not considered it	68a	96	89a	134
Reasons for switching medication
It does not work as well as expected
No	100	41	100	16	N/A
It is too expensive
No	93a	38	38a	6	<0.0001
Yes	7a	3	63a	10
It is not covered by my insurance
No	100a	41	81a	13	0.004
Yes	0a	0	19a	3
It interferes with another medication I need to take
No	100a	41	94a	15	0.106
Yes	0a	0	6a	1
I am allergic/had an allergic reaction
No	100	41	100	16	N/A
I have experienced stomach-related/gastrointestinal side effects (such as stomach pain, ulcers, blood in urine or stools)
No	98	40	94	15	0.482
Yes	2	1	6	1
I have experienced side effects that were not stomach-related
No	93	38	88	14	0.534
Yes	7	3	13	2
I had a serious reaction/side effect
No	96a	39	100a	16	0.368
Yes	5a	2	0a	0
It is too much of a hassle to take as prescribed
No	81	33	88	14	0.532
Yes	20	8	13	2
I am not able to monitor my blood as frequently as necessary
No	81	33	88	14	0.532
Yes	20	8	13	2
It is interfering with my lifestyle
No	88a	36	100a	16	0.144
Yes	12a	5	0a	0

Note:

a Values are significantly different at P<0.05 in the two-sided test of equality for column proportions and equality of means.

Abbreviations: WUs, warfarin users; NAUs, newer anticoagulant users.