Oral anticoagulant therapy is widely used for the prevention and treatment of thromboembolic diseases, yet it imposes significant burdens on patients’ health-related quality of life (HRQoL). This study aimed to compare the performance of two generic preference-based measures (GPBMs), the EQ-5D-5 L and SF-6D, in assessing HRQoL among patients receiving oral anticoagulant therapy, and to further explore the factors influencing their HRQoL. A multicenter, cross-sectional survey was conducted across 14 hospitals in China. Patients receiving oral anticoagulant therapy were enrolled and completed the EQ-5D-5 L, SF-6D, anticoagulation satisfaction (assessed by DASS), health literacy (assessed by HLS-SF9), and self-efficacy (assessed by NGSES-SF). Ceiling and floor effects, the association and agreement between the two measures, known-group validity and multi-factor analysis were assessed. A total of 379 patients receiving oral anticoagulant therapy were included in the analysis. The mean (standard deviation) utility scores were 0.837 (0.187) for the EQ-5D-5 L and 0.729 (0.132) for SF-6D. The EQ-5D-5 L demonstrated a higher ceiling effect (21.11%) compared with SF-6D (1.32%). The Pearson’s correlation coefficient between EQ-5D-5 L and SF-6D was 0.724, and the intraclass correlation coefficient (ICC) was 0.557. Patients with higher anticoagulation satisfaction, health literacy, and self-efficacy reported significantly better quality of life. The EQ-5D-5 L showed better ability to distinguish differences in a wider range of clinical factors, including the type of thrombotic diseases, anticoagulant medications, and comorbidities, compared with the SF-6D, which only detected differences in the duration of anticoagulation, number of medications, and history of thrombotic events. Both EQ-5D-5 L and SF-6D demonstrated satisfactory construct validity in assessing patients undergoing oral anticoagulant therapy, with EQ-5D-5 L showing a higher ceiling effect and superior discriminative ability for disease-specific differentiation. Given the distinct characteristics and performance of the EQ-5D-5 L and SF-6D, these instruments should not be used interchangeably in patients receiving anticoagulant therapy. These findings offer valuable insights for optimizing HRQoL assessment and management in patients receiving oral anticoagulant therapy.
Dong et al. (Fri,) studied this question.