Márquez-Contreras Emilio, Martell-Claros Nieves, Gil-Guillén Vicente, De la Figuera-Von Wichmann Mariano, Sánchez-López Eugenio, Gil-Gil Ines, Márquez-Rivero Sara
Unidad de Gestión Clínica La Orden, C/PUERTO, 6º D, 21003, Huelva, Spain.
Medicina Interna, Hospital San Carlos Madrid, Madrid, Spain.
Qual Life Res. 2017 Mar;26(3):647-654. doi: 10.1007/s11136-016-1489-x. Epub 2017 Jan 6.
To assess the quality of life (QOL) with rivaroxaban in patients with non-valvular atrial fibrilation (NVAF) related to therapeutic compliance.
Prospective, longitudinal, multicenter study was developed in 160 Spanish primary or specialized care centers. We included 412 patients treated with rivaroxaban, prescribed for stroke prevention. Three visits were conducted: baseline, 6 and 12 months. Compliance was measured by electronic monitoring systems. QOL was measured by a specific questionnaire. We calculated the percentage of compliance means, the percentage of daily compliers and the score of QOL.
Three hundred and seventy patients finished the study (mean age 75.19 SD: 7.5 years). Daily compliance was 83.5% (CI 78.53-88.57%) (n = 309) and 80% (CI 74.65-85.35%) at 6 and 12 months, respectively. Average QOL rating was 112.85 (SD 29.31) in non-compliant and 111.80 (SD 29.31) in the compliant group (p = Not significant), and after 12 months of 124.67 (SD 30.78) and 83.47 (SD 26.44), respectively (p < 0.0001), with a decrease in the score compliers (p < 0.01) and an increase in non-compliant group (p < 0.05). A higher number of drugs consumed, as well as the number of diseases/conditions suffered, the older age of the patients and having been previously treated with VKA were associated with a higher overall score (worse QOL).
QOL in NVAF patients treated with rivaroxaban improved significantly over the study group at the expense of compliers. A worse QOL was associated with pluripathology, polymedication, older patients and previous treatment with VKA.
评估利伐沙班治疗非瓣膜性心房颤动（NVAF）患者的生活质量（QOL）与治疗依从性的关系。
在西班牙160个初级或专科护理中心开展了一项前瞻性、纵向、多中心研究。我们纳入了412例接受利伐沙班治疗以预防卒中的患者。进行了三次访视：基线访视、6个月访视和12个月访视。通过电子监测系统测量依从性。通过特定问卷测量生活质量。我们计算了依从性均值百分比、每日依从者百分比和生活质量评分。
370例患者完成了研究（平均年龄75.19岁，标准差：7.5岁）。每日依从率在6个月和12个月时分别为83.5%（可信区间78.53 - 88.57%）（n = 309）和80%（可信区间74.65 - 85.35%）。非依从组的平均生活质量评分为112.85（标准差29.31），依从组为111.80（标准差29.31）（p = 无显著差异），12个月后分别为124.67（标准差30.78）和83.47（标准差26.44）（p < 0.0001），依从组评分下降（p < 0.01），非依从组评分上升（p < 0.05）。服用药物数量较多、所患疾病/病症数量较多、患者年龄较大以及既往接受过维生素K拮抗剂（VKA）治疗与总体评分较高（生活质量较差）相关。
接受利伐沙班治疗的NVAF患者的生活质量在研究期间有显著改善，但依从者的生活质量有所下降。较差的生活质量与多种疾病、多种药物治疗、老年患者以及既往VKA治疗有关。
