Impact of Direct Oral Anticoagulants Versus Vitamin K Antagonists on Quality of Life: A Cross-Sectional Study Using PACT-Q2 and EQ-5D-3L Questionnaires in Algerian Patients

Background. Vitamin K antagonists (VKAs) and direct oral anticoagulants (DOACs) are both effective in preventing thromboembolic events; however, they differ in terms of treatment burden, which may influence patients’ quality of life (QoL). This study aimed to assess and compare treatment satisfaction and health-related quality of life (HRQoL) among Algerian patients treated with DOACs versus VKAs. Methods. A cross-sectional study was conducted in Algiers between February and May 2024, including 63 adult patients receiving either VKAs or DOACs. Patient-reported outcomes were assessed using two validated instruments: the Perception of Anticoagulant Treatment Questionnaire (PACT-Q2) to evaluate treatment satisfaction and the EQ-5D3L to measure HRQoL. An additional exploratory question assessing the perceived overall impact of treatment on QoL was analyzed and crosstabulated with EQ-5D outcomes. Results. Patients treated with DOACs reported significantly higher treatment satisfaction and utility scores compared to those on VKAs. The mean PACT-Q2 score was 1.3 in the DOAC group versus 4.52 in the VKA group, indicating a lower perceived treatment burden with DOACs. The average EQ-5D-3L utility score was 0.57 in the DOAC group and 0.50 in the VKA group. Patients who transitioned from VKAs to DOACs demonstrated improved HRQoL (utility score increased from 0.44 to 0.53), whereas those who switched from DOACs to VKAs experienced a decline (from 0.47 to 0.43). Lower HRQoL was associated with greater anxiety, discomfort, and limitations in usual activities. Conclusion. In realworld Algerian settings, DOACs are associated with higher treatment satisfaction and better HRQoL compared to VKAs. These findings support the integration of patient-centered criteria into anticoagulant selection, particularly in resource-constrained environments.