Why the study?
Treatment satisfaction contributes importantly to oral anticoagulant adherence in AF, but patient satisfaction over time and associated patient characteristics needed evaluation using validated instruments.
Does the type of oral anticoagulant (DOAC vs VKA) affect treatment satisfaction in patients with atrial fibrillation?
Does the type of oral anticoagulant (DOAC vs VKA) affect treatment satisfaction in patients with atrial fibrillation?
Patients with atrial fibrillation report high overall satisfaction with oral anticoagulants, with complex and relatively minor differences in satisfaction profiles between DOACs and VKAs.
Answers are grounded in this paper and cite their sources.
High satisfaction with OACs in AF supports adherence monitoring; leaves open whether it predicts outcomes or differs in non-specialty settings.
BACKGROUND: Satisfaction with treatment has been identified as an important contributing factor to adherence with oral anticoagulant (OAC) therapy in patients with atrial fibrillation (AF). We aimed to evaluate the satisfaction level of patients with AF regarding OAC use over time, using validated patient-reported outcome instruments, and to identify associated patient characteristics. METHODS: Participants were recruited from specialized AF clinics in Canada. Eligible AF patients who were prescribed OACs were followed for up to 2 years. Participants were interviewed via telephone every 3-4 months using a structured survey. The Treatment Satisfaction Questionnaire for Medication (TSQM II) and the Anti-Clot Treatment Scale (ACTS) were used to measure satisfaction over time. RESULTS: Among the 306 participants, satisfaction scores on the TSQM II and ACTS instruments were high. Unadjusted analyses showed significantly greater satisfaction with the burden of therapy with direct OACs (DOACs) compared to that with warfarin (small-magnitude effect) and greater satisfaction with the convenience of rivaroxaban, compared with that of all other OACs (moderate-magnitude effect). After adjustment for all other variables, vitamin K antagonist therapy was associated with greater global satisfaction than was DOAC treatment. Satisfaction with benefit and burden as measured by the ACTS scale, and global satisfaction on the TSQM II scale, tended to increase over time. Patient factors that were somewhat consistently associated with greater satisfaction were female sex and younger age. CONCLUSIONS: Patients with AF were highly satisfied with their therapy, with few differences among OAC classes and individual OACs. Individual patients may or may not be more satisfied with DOAC than VKA therapy, and regardless of the OAC prescribed, the may require significant support to maintain therapy adherence.
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Salmasi et al. (2021) studied this question.
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