Direct oral anticoagulants were associated with better quality of life than vitamin K antagonists in VTE outpatients, though therapeutic adherence was only moderate for both.
Observational (n=100)
Does DOAC therapy improve adherence, quality of life, and satisfaction compared to VKA in outpatients with VTE?
DOACs offer better quality of life than VKAs for VTE outpatients, primarily due to the absence of routine blood testing, though adherence remains a challenge requiring physician-patient engagement.
INTRODUCTION: Direct oral anticoagulants (DOACs) have shown non-inferiority and ease of use compared to vitamin K antagonists (VKA) in the treatment of venous thromboembolism (VTE). No study so far has been directed toward real-life experience of outpatients receiving anticoagulants for VTE in France. METHODS: This is an observational descriptive real-life epidemiological study, using three validated questionnaires (Morisky Medication Adherence Scale-8, EQ-5D, and part 2 of the Perception of Anticoagulant Treatment Questionnaire), to assess adherence, quality of life, and satisfaction in 100 VTE outpatients receiving anticoagulation therapy by VKA (primary or switched from DOAC to VKA) or by DOAC (primary or switched from VKA to DOAC). RESULTS: Patients were very much satisfied with their treatment in both DOAC and VKA groups. Despite advantages of DOACs, therapeutic adherence was only moderate. The best adherence scores were observed in the primary VKA switched to DOAC for at least 3 months (S-DOAC) subgroup. Quality of life was better in the DOAC group mainly because of the absence of the requirement for blood testing. Most of the complaints concerned the pain/discomfort dimension in the VKA group and anxiety/depression dimension in the DOAC group. CONCLUSION: Patients were satisfied with their anticoagulant treatment, especially when they were involved in choosing the anticoagulant, and the treatment suited them. Quality of life of patients in the DOAC group was better than in the VKA group, but adherence remains to be improved. This study highlights the importance of the physician-patient relationship, pretreatment initiation, and follow-up of any anticoagulation therapy throughout.
Keita et al. (2017) conducted an observational in venous thromboembolism (n=100). Direct oral anticoagulants (DOACs) vs. Vitamin K antagonists (VKA) was evaluated on Adherence, quality of life, and satisfaction. Direct oral anticoagulants were associated with better quality of life than vitamin K antagonists in VTE outpatients, though therapeutic adherence was only moderate for both.