Division of Hospital Medicine, University of California, San Francisco, San Francisco, CA, USA.
Division of Research, Kaiser Permanente Northern California, Oakland, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA; Department of Medicine, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, CA, USA; Department of Medicine, Stanford University, Palo Alto, CA, USA.
Thromb Res. 2022 Aug;216:97-102. doi: 10.1016/j.thromres.2022.06.008. Epub 2022 Jun 28.
Venous thromboembolism (VTE) is commonly treated with oral anticoagulants, including warfarin or direct oral anticoagulants (DOACs). Although DOACs are associated with favorable treatment satisfaction, few studies have assessed whether quality of life differs between DOAC and warfarin users.
We invited adults enrolled in two California-based integrated health care delivery systems and with a history of VTE between January 1, 2015 and June 30, 2018 to complete a survey on their experience with anticoagulants. Health-related quality of life (QOL) was assessed using the RAND 36-item Short Form Health Survey (SF-36), which measures QOL in 2 general component scores (physical and mental). We used multivariable linear regression to compare mean QOL component scores between DOAC-users and warfarin-users, adjusting for patient and clinical characteristics.
Overall, 2230 patients (43.1 % women and 31.8 % >75 years of age) taking anticoagulants answered at least 1 question on the SF-36, 975 taking DOACs and 1255 taking warfarin. After adjustment for patient-level factors, there were no significant differences in either physical component scores (39.2 v 38.3, p = 0.24) or mental component scores (48.5 v 49.0, p = 0.42) between DOAC and warfarin users.
Health-related QOL did not significantly differ between DOAC and warfarin users with a history of VTE.
静脉血栓栓塞症（VTE）通常采用口服抗凝剂治疗，包括华法林或直接口服抗凝剂（DOAC）。虽然 DOAC 与良好的治疗满意度相关，但很少有研究评估 DOAC 和华法林使用者的生活质量是否存在差异。
我们邀请了 2015 年 1 月 1 日至 2018 年 6 月 30 日期间在加利福尼亚州两个综合医疗服务提供系统中登记且有 VTE 病史的成年人完成关于他们抗凝治疗经验的调查。使用 RAND 36 项简短健康调查（SF-36）评估健康相关生活质量（QOL），该调查使用 2 个一般组成部分评分（身体和心理）来衡量 QOL。我们使用多变量线性回归比较 DOAC 使用者和华法林使用者的平均 QOL 组成部分评分，同时调整患者和临床特征。
总体而言，2230 名服用抗凝剂的患者（43.1%为女性，31.8%年龄>75 岁）回答了 SF-36 的至少 1 个问题，其中 975 名服用 DOAC，1255 名服用华法林。在调整患者水平因素后，DOAC 和华法林使用者的身体成分评分（39.2 比 38.3，p=0.24）或心理成分评分（48.5 比 49.0，p=0.42）均无显著差异。
有 VTE 病史的 DOAC 和华法林使用者的健康相关 QOL 没有显著差异。
