Key result
Rural patients on long-term VKA therapy were more likely to be unaware of NOACs than metropolitan patients and perceived fewer benefits in transitioning.
Why the study?
What are patients' perspectives regarding long-term VKA therapy and the potential transition to NOACs?
Cross-Sectional (n=290)
Yes
What are patients' perspectives regarding long-term VKA therapy and the potential transition to NOACs?
Patients on long-term VKA therapy are generally satisfied and perceive more deterrents than benefits to transitioning to NOACs, particularly in rural areas where awareness is lower.
Answers are grounded in this paper and cite their sources.
May support rural NOAC education efforts; leaves open impact on transition rates in prospective studies.
OBJECTIVES: To examine patients' perspectives regarding long-term vitamin K antagonist (VKA) therapy and the potential transition to new oral anticoagulants (NOACs) such as dabigatran and rivaroxaban, and to determine if factors such as residential location affect these opinions. DESIGN SETTING AND PARTICIPANTS: Patients on VKA therapy for at least 12 weeks completed a questionnaire specifically designed for the study. They were recruited while attending point-of-care international normalized ratio (INR) testing at six South Australian general practice clinics during the period July-September 2013. MAIN OUTCOME MEASURES: Opinions of current VKA therapy, level of awareness of NOACs, and ratings of potential benefits and deterrents of transition to NOACs were sought. RESULTS: Data from 290 participants were available for analysis (response rate 95.4%). The majority of the sample (79.5%, 229/288) were either satisfied or very satisfied with current VKA therapy. The mean score for the potential benefits of transition to NOACs was 7.6 (±4.2) out of a possible 20, which was significantly lower than the mean score 10.9 (±4.5) for the perceived deterrents to transition (p < 0.001). Rural patients (82.0%, 82/100) were significantly more likely (p = 0.001) to have not heard of NOACs than metropolitan patients (50.3%, 95/189) and also perceived significant less benefits in a transition to NOACs (p = 0.001). CONCLUSION: When considering potential transition from VKAs to NOACs it is important for prescribers to consider that some patients, in particular those from a rural location, may not perceive a significant benefit in transitioning or may have particular concerns in this area.
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Gebler-Hughes et al. (2014) conducted a cross-sectional in Long-term vitamin K antagonist (VKA) therapy (n=290). Rural residential location vs. Metropolitan residential location was evaluated on Lack of awareness of NOACs (p=0.001). Rural patients on long-term VKA therapy were more likely to be unaware of NOACs than metropolitan patients and perceived fewer benefits in transitioning.
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