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患者对华法林的满意度及改用达比加群的意愿:一项患者调查

Patients satisfaction with warfarin and willingness to switch to dabigatran: a patient survey.

作者信息

Elewa Hazem F, DeRemer Christina E, Keller Kimble, Gujral Jaspal, Joshua Thomas V

机构信息

Pharmacy Department, Georgia Regents Health System, 1120 15th Street, BI 2101, Augusta, GA, 30912, USA,

出版信息

J Thromb Thrombolysis. 2014 Jul;38(1):115-20. doi: 10.1007/s11239-013-0976-y.

Abstract

Warfarin is an anticoagulant medication that is challenging to manage. Dabigatran has been approved by the FDA for stroke and systemic embolism prevention in non-valvular atrial fibrillation as an alternative to warfarin. Dabigatran does not require routine monitoring, has an established dose, and lacks many of the drug, herbal, and food interactions that afflict warfarin. To evaluate patients' satisfaction with their current warfarin treatment and their opinion on switching to a newly marketed medication (dabigatran) through a brief survey. Two separate surveys were administered to (1) evaluate the patients' opinion of their warfarin therapy and (2) evaluate their thoughts on switching to a newer anticoagulant. Responses were recorded on a rating scale of 1-5; 1 being the least and 5 being the highest. Study was conducted at the Georgia Regents Health System (GRHS) pharmacy-based anticoagulation clinic. Two hundred sixty patients on warfarin treatment were enrolled. Patients expressed high satisfaction with warfarin treatment (4.7 ± 0.78). However, a vast majority of the patients were willing to switch to an agent that: requires less frequent follow-up visits (3.9 ± 1.35); lacks interaction with food and/or beverage (4.1 ± 1.25); is as efficacious as warfarin (3.7 ± 1.38). Patients expressed that out-of-pocket cost would be a major barrier to switch to this new medication (1.3 ± 0.58). Patients are satisfied with their warfarin treatment but willing to consider a new anticoagulant. Cost was highlighted as the most significant barrier. Efficacy, dietary freedom and less frequent visits are the major factors affecting the patients' decision.

摘要

华法林是一种难以管理的抗凝血药物。达比加群已获美国食品药品监督管理局(FDA)批准,可作为华法林的替代品,用于预防非瓣膜性心房颤动患者的中风和全身性栓塞。达比加群无需常规监测,有既定剂量,且不存在困扰华法林的许多药物、草药和食物相互作用。通过一项简短调查评估患者对当前华法林治疗的满意度以及他们对改用新上市药物(达比加群)的看法。对患者进行了两项单独的调查:(1)评估患者对华法林治疗的看法;(2)评估他们对改用新型抗凝血剂的想法。回答记录在1 - 5分的评分量表上;1分为最低,5分为最高。该研究在佐治亚州医科大学健康系统(GRHS)基于药房的抗凝门诊进行。招募了260名接受华法林治疗的患者。患者对华法林治疗表示高度满意(4.7±0.78)。然而,绝大多数患者愿意改用一种:随访就诊次数更少(3.9±1.35);与食物和/或饮料无相互作用(4.1±1.25);与华法林疗效相当(3.7±1.38)的药物。患者表示自付费用将是改用这种新药的主要障碍(1.3±0.58)。患者对华法林治疗感到满意,但愿意考虑使用新型抗凝血剂。费用被视为最主要的障碍。疗效、饮食自由度和就诊次数减少是影响患者决策的主要因素。

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