Why the study?
It was unknown whether long-term treatment with DOACs offers a better quality of life than VKAs in real-life practice.
Do direct oral anticoagulants improve quality of life compared to vitamin K antagonists in patients requiring chronic oral anticoagulation?
Do direct oral anticoagulants improve quality of life compared to vitamin K antagonists in patients requiring chronic oral anticoagulation?
Long-term DOAC therapy provides a significantly better quality of life and imposes fewer daily limitations and hassles than VKA therapy, though the lack of routine monitoring may cause minor psychological concern for some patients.
Supports DOAC selection to minimize anticoagulation burden; leaves open causal confirmation without randomized trials.
BACKGROUND: Direct oral anticoagulants (DOACs) are widely used in patients with atrial fibrillation and venous thromboembolism. The lack of the need for laboratory monitoring and a better safety than vitamin K antagonists (VKAs) has probably changed the quality of life of patients on these oral anticoagulants. This was a real-life prospective observational cohort study. The aim was to evaluate if a long-term treatment with DOACs could offer a better quality of life than VKAs. Moreover, age, gender, education level, time in therapeutic range for VKAs, taking medication once or twice a day for DOACs, the total daily number of medications and thrombotic and bleeding complications were considered as variables probably associated with the quality of life of these patients. METHODS: Between January and December 2021, the Duke Anticoagulation Satisfaction Scale (DASS) 25-items was administered as an interview to patients on either VKAs or DOACs therapy. During the follow-up period, all of the patients were closely monitored to evaluate possible bleeding and thrombotic events. CONCLUSIONS: VKAs negatively influence the daily-life of the patients in terms of both less satisfaction and time-consuming tasks. DOACs confer a better quality of life even if some concerns emerge from not knowing how their therapy is working.
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Mameli et al. (2023) studied this question.
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