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非瓣膜性心房颤动患者中,与直接口服抗凝剂相比,患者对维生素K拮抗剂的负担和益处的满意度、生活质量及认知情况。

Satisfaction, quality of life and perception of patients regarding burdens and benefits of vitamin K antagonists compared with direct oral anticoagulants in patients with nonvalvular atrial fibrillation.

作者信息

Contreras Muruaga Ma Del Mar, Vivancos José, Reig Gemma, González Ayoze, Cardona Pere, Ramírez-Moreno José Mª, Martí Joan, Suárez Fernández Carmen

机构信息

Servicio de Medicina Interna, Hospital Universitario de La Princesa, Madrid, Spain.

Servicio de Neurología, Hospital Universitario de La Princesa, Madrid, Spain.

出版信息

J Comp Eff Res. 2017 Jun;6(4):303-312. doi: 10.2217/cer-2016-0078. Epub 2017 Mar 29.

Abstract

AIM

To compare the satisfaction of patients treated with vitamin K antagonists (VKA) with that of patients treated with direct oral anticoagulants (DOACs) and to determine the impact on quality of life of both treatments in patients with nonvalvular atrial fibrillation (NVAF).

METHODS

Cross-sectional multicenter study in which outpatients with NVAF completed the ACTS (Anti-Clot Treatment Scale), SAT-Q (Satisfaction Questionnaire) and EQ-5D-3L (EuroQol 5 dimensions questionnaire, 3 level version) questionnaires.

RESULTS

The study population comprised 1337 patients, of whom 587 were taking DOACs and 750 VKAs. Compared with VKAs, DOACs were more commonly prescribed in patients with a history of stroke and in patients with a higher thromboembolic risk. The study scores were as follows: SAT-Q: 63.8 ± 17.8; EQ-5D-3L total score: 75.6 ± 20.9; visual analog scale: 63.1 ± 20.6; ACTS Burdens: 51.8 ± 8.4 and ACTS Benefits: 11.9 ± 2.4. The ACTS Burdens score and ACTS Benefits score were higher with DOACs than with VKAs (54.83 ± 6.11 vs 49.50 ± 9.15; p < 0.001 and 12.36 ± 2.34 vs 11.48 ± 2.46; p < 0.001 respectively).

CONCLUSION

NVAF patients treated with oral anticoagulants had many comorbidities and a high thromboembolic risk. Satisfaction and quality of life with oral anticoagulants were high, although they were both better with DOACs than with VKAs.

摘要

目的

比较接受维生素K拮抗剂(VKA)治疗的患者与接受直接口服抗凝剂(DOAC)治疗的患者的满意度,并确定这两种治疗方法对非瓣膜性心房颤动(NVAF)患者生活质量的影响。

方法

进行横断面多中心研究,让NVAF门诊患者完成ACTS(抗凝血治疗量表)、SAT-Q(满意度问卷)和EQ-5D-3L(欧洲五维度健康量表,3水平版本)问卷。

结果

研究人群包括1337名患者,其中587名服用DOAC,750名服用VKA。与VKA相比,DOAC在有中风病史和血栓栓塞风险较高的患者中更常被处方。研究得分如下:SAT-Q:63.8±17.8;EQ-5D-3L总分:75.6±20.9;视觉模拟量表:63.1±20.6;ACTS负担:51.8±8.4,ACTS益处:11.9±2.4。DOAC的ACTS负担得分和ACTS益处得分高于VKA(分别为54.83±6.11对49.50±9.15;p<0.001和12.36±2.34对11.48±2.46;p<0.001)。

结论

接受口服抗凝剂治疗的NVAF患者有许多合并症且血栓栓塞风险高。口服抗凝剂的满意度和生活质量较高,尽管DOAC的满意度和生活质量均优于VKA。

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