Paediatric and Congenital Cardiology Department, Clinical Investigation Centre, Arnaud-De-Villeneuve University Hospital, M3C Regional Reference Centre, 34295 Montpellier, France; Public Health and Chronic Diseases Laboratory, Centre for Studies and Research into Health Services and Quality of Life, Aix-Marseille University, 13385 Marseille, France.
Paediatric Cardiology Department, Hôpital Necker-Enfants malades, AP-HP, M3C National Reference Centre, Paris-Descartes University, Sorbonne Paris Cité, 75015 Paris, France.
Arch Cardiovasc Dis. 2020 Dec;113(12):811-820. doi: 10.1016/j.acvd.2020.05.022. Epub 2020 Oct 14.
Managing oral anticoagulant therapy with vitamin K antagonists remains challenging in paediatric medicine.
This study aimed to assess the correlation between time in therapeutic range and quality of life in children participating in a non-selective International Normalised Ratio self-monitoring and vitamin K antagonist education programme.
Children aged from 2 to 18 years and receiving vitamin K antagonist therapy were eligible for this prospective multicentre study. Clinical and demographic data were collected. Health-related quality of life was assessed using the PedsQL™ 4.0 questionnaire. Correlations between quality of life scores and time in therapeutic range were measured.
A total of 121 children were included in the study (mean age 9.6±4.9 years). Cardiac conditions were the predominant indication for vitamin K antagonists. The mean time in therapeutic range was 0.78±0.15 overall, and 0.76±0.24 over the 3-month period before quality of life assessment. The mean total quality of life score was 76.2±18 in self reports, 71.4±22 in mother reports and 73.5±19 in father reports. The time in therapeutic range correlated with the total quality of life scores in self reports (r=0.22; P=0.04), mother reports (r=0.23; P=0.02) and father reports (r=0.28; P=0.02). The time in therapeutic range predominantly correlated with school functioning in self reports (r=0.38; P=0.002) and mother reports (r=0.40; P<0.001), and with physical functioning in father reports (r=0.28; P=0.03).
Time in therapeutic range correlated with quality of life in children participating in a non-selective International Normalised Ratio self-monitoring and vitamin K antagonist education programme. Regular assessment of quality of life in patient education programmes contributes towards understanding the concerns and needs of patients.
管理维生素 K 拮抗剂的口服抗凝治疗在儿科医学中仍然具有挑战性。
本研究旨在评估参与非选择性国际标准化比值自我监测和维生素 K 拮抗剂教育计划的儿童的治疗范围内时间与生活质量之间的相关性。
本前瞻性多中心研究纳入了年龄在 2 至 18 岁之间并接受维生素 K 拮抗剂治疗的儿童。收集了临床和人口统计学数据。使用 PedsQL™ 4.0 问卷评估与健康相关的生活质量。测量生活质量评分与治疗范围内时间之间的相关性。
共有 121 名儿童纳入本研究（平均年龄 9.6±4.9 岁）。心脏疾病是维生素 K 拮抗剂的主要适应证。整体而言，治疗范围内的平均时间为 0.78±0.15，在进行生活质量评估前的 3 个月内为 0.76±0.24。自我报告的总生活质量评分为 76.2±18，母亲报告的为 71.4±22，父亲报告的为 73.5±19。治疗范围内的时间与自我报告的总生活质量评分（r=0.22；P=0.04）、母亲报告（r=0.23；P=0.02）和父亲报告（r=0.28；P=0.02）相关。治疗范围内的时间主要与自我报告的学校功能（r=0.38；P=0.002）和母亲报告的学校功能（r=0.40；P<0.001）以及父亲报告的身体功能（r=0.28；P=0.03）相关。
在参与非选择性国际标准化比值自我监测和维生素 K 拮抗剂教育计划的儿童中，治疗范围内的时间与生活质量相关。在患者教育计划中定期评估生活质量有助于了解患者的关注点和需求。
Zotero 插件