Comparing quality of life and treatment satisfaction between patients on warfarin and direct oral anticoagulants: a cross-sectional study
Comparing quality of life and treatment satisfaction between patients on warfarin and direct oral anticoagulants: a cross-sectional study
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DOI：
10.2147/ppa.s204246
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发表时间：
2019-01-01
影响因子：
2.2
通讯作者：
Bee, Ping-Chong
中科院分区：
文献类型：
--
作者：
Ng, Diana Leh-Ching;Gan, Gin-Gin;Bee, Ping-Chong
前言和目的：近年来，由于医疗保健的进步带来了预期寿命的延长，长期口服抗凝治疗的患者生活质量（QOL）受到越来越多的关注。本研究旨在比较长期使用华法林与直接口服抗凝药物（DOAC）患者的生活质量、治疗满意度、住院率和出血率。方法：这是一项横断面研究，研究对象是2016年7月1日至2018年6月30日在马来亚大学医学中心心脏病学诊所和抗凝诊所接受长期抗凝治疗的非瓣膜性心房颤动（NVAF）或静脉血栓栓塞（VTE）患者。采用短表12健康调查（SF12）评估患者的生活质量，采用抗凝治疗感知问卷2 （PACT-Q2）评估治疗满意度。结果：共纳入患者208例；52.4%的患者接受华法林治疗，47.6%的患者接受DOAC治疗。基于SF12的华法林与DOAC的生活质量差异无统计学意义（生理生活质量，P=0.083；精神生活质量，P=0.665）。然而，基于PACT-Q2， DOAC组患者对治疗的满意度明显高于华法林组（P=0.004）。华法林组住院率显著高于DOAC组（15.6%比3.0%，P=0.002）。华法林组临床相关轻微出血和严重出血事件发生率均高于DOAC组（66.7% vs 40.0%， P=0.069）。结论：与华法林相比，DOAC治疗非瓣膜性房颤和静脉血栓栓塞的生活质量相当，治疗满意度较高，住院率较低，出血发生率无明显趋势。
Introduction and aim: Patient quality of life (QOL) while on long-term oral anticoagulant therapy has been receiving greater attention in recent years due to the increase in life expectancy brought about by advances in medical care. This study aimed to compare the QOL, treatment satisfaction, hospitalization and bleeding rate in patients on long-term warfarin versus direct oral anticoagulants (DOAC).Methods: This was a cross-sectional study of patients with non-valvular atrial fibrillation (NVAF) or venous thromboembolism (VTE) on long-term anticoagulant therapy attending the cardiology clinic and anticoagulation clinic of the University Malaya Medical Centre from July 1, 2016, to June 30, 2018. Patient QOL was assessed by using the Short Form 12 Health Survey (SF12), while treatment satisfaction was assessed by using the Perception of Anticoagulation Treatment Questionnaire 2 (PACT-Q2).Results: A total of 208 patients were recruited; 52.4% received warfarin and 47.6% received DOAC. There was no significant difference in QOL between warfarin and DOAC based on SF12 (physical QOL, P=0.083; mental QOL, P=0.665). Nevertheless, patients in the DOAC group were significantly more satisfied with their treatment compared to the warfarin group based on PACT-Q2 (P=0.004). The hospitalisation rate was significantly higher in the warfarin group than the DOAC group (15.6% versus 3.0%, P=0.002). Clinically relevant minor bleeds and severe bleeding events were non-significantly higher in the warfarin group than the DOAC group (66.7% versus 40.0%, P=0.069).Conclusion: Compared to warfarin, treatment of NVAF and VTE with DOAC showed comparable QOL, higher treatment satisfaction, lesser hospitalization, and a non-significant trend toward fewer bleeding episodes.