Hospital HM Montepríncipe, Boadilla del Monte, Madrid, Spain.
Hospital San Juan de Alicante, San Juan de Alicante, Alicante, Spain.
Health Qual Life Outcomes. 2020 Dec 11;18(1):383. doi: 10.1186/s12955-020-01563-1.
There is a dearth of evidence regarding Health-Related Quality of Life (HRQoL) in nonvalvular atrial fibrillation (NVAF) patients undergoing oral anticoagulation therapy. Our objective was to describe HRQoL in NVAF patients on oral anticoagulation, focusing on uncontrolled patients on vitamin K antagonists (VKAs) versus controlled patients on VKAs or non-vitamin K antagonist oral anticoagulants (NOACs), in a real-world setting. Additionally, we assessed the clinical characteristics of patients with uncontrolled anticoagulation.
An observational, multicentre, and cross-sectional study, enrolling 38 Spanish Hospitals' Internal Medicine Departments. HRQoL was assessed using the validated Spanish version of the Sawicki questionnaire. High self-perceived HRQoL was indicated by high scores in the general treatment satisfaction and self-efficacy dimensions, and by low scores in the strained social network, daily hassles and distress dimensions.
Five hundred and one patients were included for assessment. Mean scores ± SD were closer to a high perceived HRQoL in controlled than uncontrolled patients for the five dimensions of the questionnaire: 4.9 ± 1.0 versus 3.6 ± 1.3 for general treatment satisfaction; 4.3 ± 1.0 versus 3.6 ± 1.0 for self-efficacy, 3.1 ± 0.9 versus 3.9 ± 1.1 for strained social network, 2.1 ± 0.8 versus 3.0 ± 1.0 for daily hassles and 1.8 ± 0.9 versus 2.6 ± 1.2 for distress.
HRQoL in patients with controlled anticoagulant status treated with NOACs or VKAs was better than in patients with uncontrolled anticoagulant status. This seems to indicate that anticoagulation control status influences perception of HRQoL, highlighting the importance of its evaluation when assessing HRQoL in NVAF patients.
在接受口服抗凝治疗的非瓣膜性心房颤动（NVAF）患者中，健康相关生活质量（HRQoL）的证据不足。我们的目的是描述 NVAF 患者口服抗凝治疗的 HRQoL，重点关注维生素 K 拮抗剂（VKA）未控制患者与 VKA 或非维生素 K 拮抗剂口服抗凝剂（NOAC）控制患者之间的差异，这是在真实环境中进行的。此外，我们评估了抗凝未控制患者的临床特征。
这是一项观察性、多中心、横断面研究，共纳入了 38 家西班牙医院的内科。使用经过验证的西班牙语版 Sawicki 问卷评估 HRQoL。高自我感知 HRQoL 通过高得分的一般治疗满意度和自我效能维度，以及低得分的紧张社交网络、日常困扰和痛苦维度来表示。
共纳入 501 例患者进行评估。与未控制患者相比，控制患者在问卷的五个维度中更接近高感知 HRQoL，包括：一般治疗满意度维度（4.9±1.0 对 3.6±1.3）；自我效能维度（4.3±1.0 对 3.6±1.0）；紧张社交网络维度（3.1±0.9 对 3.9±1.1）；日常困扰维度（2.1±0.8 对 3.0±1.0）；痛苦维度（1.8±0.9 对 2.6±1.2）。
NOAC 或 VKA 治疗的抗凝控制患者的 HRQoL 优于抗凝未控制患者。这似乎表明抗凝控制状态会影响 HRQoL 的感知，强调在评估 NVAF 患者的 HRQoL 时评估抗凝控制状态的重要性。
