Anticoagulant treatment satisfaction with warfarin and direct oral anticoagulants for venous thromboembolism.
Anticoagulant treatment satisfaction with warfarin and direct oral anticoagulants for venous thromboembolism.
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DOI：
10.1007/s11239-021-02437-z
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发表时间：
2021-11
影响因子：
4
通讯作者：
Reynolds K
中科院分区：
文献类型：
--
作者：
Fang MC;Go AS;Prasad PA;Hsu JW;Fan D;Portugal C;Sung SH;Reynolds K
静脉血栓栓塞（VTE）患者的治疗选择包括华法林和直接口服抗凝剂（DOAC）。尽管DOAC比华法林更容易给药，并且不需要常规实验室监测，但很少有研究直接评估患者是否对DOAC更满意。我们调查了来自两个大型综合卫生系统的成年人，他们在2015年1月1日至2018年6月30日期间服用DOAC或华法林治疗VTE事件。使用经验证的抗凝血治疗量表（Anti-Clot Treatment Scale，简称CET）评估治疗满意度，分为CET负担和CET获益评分;评分越高表示满意度越高。平均治疗满意度采用多变量线性回归进行比较，调整患者的人口统计学和临床特征。使用Cohen d计算平均值差异的效应量（0.20被认为是小效应，≥ 0.80被认为是大效应）。我们调查了2217例患者，969例服用DOAC，1248例在调查时服用华法林。31.5%的队列年龄≥ 75岁，43.1%为女性。DOAC使用者对抗凝治疗的满意度平均更高，DOAC与华法林相比，校正后的平均住院负担（50.18 v. 48.01，p < 0.0001）和住院获益评分（10.21 v. 9.84，p = 0.046）分别更高。差异的幅度很小（科恩的d为0.29的负担和0.12的福利）。服用DOAC治疗静脉血栓栓塞的患者对抗凝治疗的满意度平均高于华法林使用者，尽管差异幅度很小。在线版本包含补充材料，可通过10.1007/s11239-021-02437-z获得。
Treatment options for patients with venous thromboembolism (VTE) include warfarin and direct oral anticoagulants (DOACs). Although DOACs are easier to administer than warfarin and do not require routine laboratory monitoring, few studies have directly assessed whether patients are more satisfied with DOACs. We surveyed adults from two large integrated health systems taking DOACs or warfarin for incident VTE occurring between January 1, 2015 and June 30, 2018. Treatment satisfaction was assessed using the validated Anti-Clot Treatment Scale (ACTS), divided into the ACTS Burdens and ACTS Benefits scores; higher scores indicate greater satisfaction. Mean treatment satisfaction was compared using multivariable linear regression, adjusting for patient demographic and clinical characteristics. The effect size of the difference in means was calculated using a Cohen’s d (0.20 is considered a small effect and ≥ 0.80 is considered large). We surveyed 2217 patients, 969 taking DOACs and 1248 taking warfarin at the time of survey. Thirty-one point five percent of the cohort was aged ≥ 75 years and 43.1% were women. DOAC users were on average more satisfied with anticoagulant treatment, with higher adjusted mean ACTS Burdens (50.18 v. 48.01, p < 0.0001) and ACTS Benefits scores (10.21 v. 9.84, p = 0.046) for DOACs vs. warfarin, respectively. The magnitude of the difference was small (Cohen’s d of 0.29 for ACTS Burdens and 0.12 for ACTS Benefits). Patients taking DOACs for venous thromboembolism were on average more satisfied with anticoagulant treatment than were warfarin users, although the magnitude of the difference was small. The online version contains supplementary material available at 10.1007/s11239-021-02437-z.
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