Health-related quality of life in nonvalvular atrial fibrillation patients with controlled or uncontrolled anticoagulation status

Health and Quality of Life Outcomes - Tập 18 - Trang 1-10 - 2020
José Felipe Varona1, José Miguel Seguí-Ripoll2,3, Cristina Lozano-Duran4, Luis Miguel Cuadrado-Gómez4, Juan Bautista Montagud-Moncho5, Antonio Ramos-Guerrero6, José Carlos Mirete-Ferrer7, Esther Donado8, Javier García-Alegría9
1Hospital HM Montepríncipe, Boadilla del Monte, Spain
2Hospital San Juan de Alicante, San Juan de Alicante, Spain
3Department of Clinical Medicine, Miguel Hernández University, Elche, Spain
4Hospital Universitario Príncipe de Asturias, Alcalá de Henares, Spain
5Hospital Francesc de Borja, Gandía, Spain
6Hospital San Juan de Dios del Aljarafe, Bormujos, Spain
7Hospital de Torrevieja, Torrevieja, Spain
8Boehringer-Ingelheim, Sant Cugat del Vallés, Spain
9Hospital Costa del Sol, Marbella, Spain

Tóm tắt

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.

Tài liệu tham khảo

Chugh SS, Havmoeller R, Narayanan K, Singh D, Rienstra M, Benjamin EJ, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014;129(8):837–47. Sankaranarayanan R, Kirkwood G, Visweswariah R, Fox DJ. How does chronic atrial fibrillation influence mortality in the modern treatment era? Curr Cardiol Rev. 2015;11(3):190–8. Alonso A, Arenas de Larriva AP. Atrial fibrillation, cognitive decline and dementia. Eur Cardiol. 2016;11(1):49–53. Batul SA, Gopinathannair R. Atrial fibrillation in heart failure: a therapeutic challenge of our times. Korean Circ J. 2017;47(5):644–62. Freeman JV, Simon DN, Go AS, Spertus J, Fonarow GC, Gersh BJ, et al. Association between atrial fibrillation symptoms, quality of life, and patient outcomes: results from the outcomes registry for better informed treatment of atrial fibrillation (ORBIT-AF). Circ Cardiovasc Qual Outcomes. 2015;8(4):393–402. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Rev Española Cardiol. 2017;70(1):033. Kamel H, Okin PM, Elkind MS, Iadecola C. Atrial fibrillation and mechanisms of stroke: time for a new model. Stroke. 2016;47(3):895–900. Carmo JFD, Morelato RL, Pinto HP, Oliveira ERAD. Disability after stroke: a systematic review. Fisioter Mov. 2015;28:407–18. Gomez-Doblas JJ, Muniz J, Martin JJ, Rodriguez-Roca G, Lobos JM, Awamleh P, et al. Prevalence of atrial fibrillation in Spain. OFRECE study results. Rev Española Cardiol. 2014;67(4):259–69. Johnsen SP, Dalby LW, Täckström T, Olsen J, Fraschke A. Cost of illness of atrial fibrillation: a nationwide study of societal impact. BMC Health Serv Res. 2017;17(1):714. Wolowacz SE, Samuel M, Brennan VK, Jasso-Mosqueda JG, Van Gelder IC. The cost of illness of atrial fibrillation: a systematic review of the recent literature. Europace. 2011;13(10):1375–85. López-López JA, Sterne JAC, Thom HHZ, Higgins JPT, Hingorani AD, Okoli GN, et al. Oral anticoagulants for prevention of stroke in atrial fibrillation: systematic review, network meta-analysis, and cost effectiveness analysis. BMJ (Clin Res Ed). 2017;359:j5058-j. Anguita Sanchez M, Bertomeu Martinez V, Cequier FA. Quality of vitamin K antagonist anticoagulation in Spain: prevalence of poor control and associated factors. Rev Española Cardiol. 2015;68(9):761–8. Reig-Rosello G, Contreras MM, Suarez-Fernandez C, Gonzalez-Hernandez A, Cardona P, Pons-Amate JM, et al. Clinical profile and satisfaction with anticoagulated treatment in patients with non-valvular atrial fibrillation attended in Internal Medicine and Neurology departments of Spain. Rev Neurol. 2017;65(8):361–7. Garcia-Sempere A, Hurtado I, Bejarano-Quisoboni D, Rodriguez-Bernal C, Santa-Ana Y, Peiro S, et al. Quality of INR control and switching to non-Vitamin K oral anticoagulants between women and men with atrial fibrillation treated with Vitamin K Antagonists in Spain. A population-based, real-world study. PLoS ONE. 2019;14(2):e0211681. Farmakis D, Davlouros P, Giamouzis G, Giannakoulas G, Pipilis A, Tsivgoulis G, et al. Direct oral anticoagulants in nonvalvular atrial fibrillation: practical considerations on the choice of agent and dosing. Cardiology. 2018;140(2):126–32. Ahlsson A, Manolis AS, Casadei B, Van Putte B, Popescu BA, Atar D, et al. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37(38):2893–962. Mani H, Lindhoff-Last E. New oral anticoagulants in patients with nonvalvular atrial fibrillation: a review of pharmacokinetics, safety, efficacy, quality of life, and cost effectiveness. Drug Des Dev Ther. 2014;8:789–98. Benzimra M, Bonnamour B, Duracinsky M, Lalanne C, Aubert JP, Chassany O, et al. Real-life experience of quality of life, treatment satisfaction, and adherence in patients receiving oral anticoagulants for atrial fibrillation. Patient Prefer Adher. 2018;12:79–877. Monz BU, Connolly SJ, Korhonen M, Noack H, Pooley J. Assessing the impact of dabigatran and warfarin on health-related quality of life: results from an RE-LY sub-study. Int J Cardiol. 2013;168(3):2540–7. Alegret JM, Vinolas X, Arias MA, Martinez-Rubio A, Rebollo P, Rafols C, et al. New oral anticoagulants versus vitamin K antagonists: benefits for health-related quality of life in patients with atrial fibrillation. Int J Med Sci. 2014;11(7):680–4. Balci KG, Balci MM, Canpolat U, Sen F, Akboga MK, Suleymanoglu M, et al. Comparison of health-related quality of life among patients using novel oral anticoagulants or warfarin for non-valvular atrial fibrillation. Anatol J Cardiol. 2016;16(7):474–81. López-Sendón J, Merino JL. Poor anticoagulation control in atrial fibrillation: how much longer? Rev Española Cardiol (Engl Ed). 2015;68(09):740–2. Van Spall HG, Wallentin L, Yusuf S, Eikelboom JW, Nieuwlaat R, Yang S, et al. Variation in warfarin dose adjustment practice is responsible for differences in the quality of anticoagulation control between centers and countries: an analysis of patients receiving warfarin in the randomized evaluation of long-term anticoagulation therapy (RE-LY) trial. Circulation. 2012;126(19):2309–16. Hasan SS, Teh KM, Ahmed SI, Chong DW, Ong HC, Naina B. Quality of life (QoL) and international normalized ratio (INR) control of patients attending anticoagulation clinics. Public Health. 2015;129(7):954–62. Rosendaal FR, Cannegieter SC, van der Meer FJ, Briet E. A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost. 1993;69(3):236–9. Pisters R, Lane DA, Nieuwlaat R, de Vos CB, Crijns HJGM, Lip GYH. A novel user-friendly score (HAS-BLED) to assess 1-year risk of major bleeding in patients with atrial fibrillation: the Euro heart survey. Chest. 2010;138(5):1093–100. Sánchez González R, Yanes Baonza M, Cabrera Majada A, Ferrer García-Borrás JM, Álvarez Nido R, Barrera LE. Adaptación transcultural de un cuestionario para medir la calidad de vida de los pacientes con anticoagulación oral. Aten Primaria. 2004;34(7):353–9. Sawicki PT. A structured teaching and self-management program for patients receiving oral anticoagulation: a randomized controlled trial. Working Group for the Study of Patient Self-Management of Oral Anticoagulation. J Am Med Assoc. 1999;281(2):145–50. Siebenhofer A, Hemkens LG, Rakovac I, Spat S, Didjurgeit U. Self-management of oral anticoagulation in elderly patients—effects on treatment-related quality of life. Thromb Res. 2012;130(3):1. Marquez-Contreras E, Martell-Claros N, Gil-Guillen V, De la Figuera-Von WM, Sanchez-Lopez E, Gil-Gil I, et al. Quality of life with rivaroxaban in patients with non-valvular atrial fibrilation by therapeutic compliance. Qual Life Res. 2017;26(3):647–54. Anguita M, Marín F, Roldán I, Cequier A, Bertomeu V, Muñiz J. Satisfaction with medical care in patients with atrial fibrillation treated with vitamin K antagonists versus new oral anticoagulants. Rev Española Cardiol (Engl Ed). 2015;68(06):537–9. Fareau S, Baumstarck K, Chiche L, Farcet A, Molines C, Auquier P, et al. Évaluation de la qualité de vie des patients âgés en fibrillation atriale sous anticoagulants au long cours : antivitamine K versus Anticoagulants oraux directs. La Revue Méd Interne. 2015;36:A175–A176176. Bartoli-Abdou JK, Patel JP, Xie R, Dzahini O, Vadher B, Brown A, et al. Associations between illness beliefs, medication beliefs, anticoagulation-related quality of life, and INR control: Insights from the Switching Study. Res Pract Thromb Haemost. 2018;2(3):497–507. Barrios V, Escobar C, Prieto L, Osorio G, Polo J, Lobos JM, et al. Anticoagulation control in patients with nonvalvular atrial fibrillation attended at primary care centers in Spain: The PAULA study. Rev Española Cardiol. 2015;68(9):769–76. Apostolakis S, Sullivan RM, Olshansky B, Lip GYH. Factors affecting quality of anticoagulation control among patients with atrial fibrillation on warfarin: the SAMe-TT(2)R(2) score. Chest. 2013;144(5):1555–633. Randolph TC, Simon DN, Thomas L, Allen LA, Fonarow GC, Gersh BJ, et al. Patient factors associated with quality of life in atrial fibrillation. Am Heart J. 2016;182:135–43. Abohelaika S, Wynne H, Avery P, Robinson B, Kesteven P, Kamali F. Impact of age on long-term anticoagulation and how gender and monitoring setting affect it: implications for decision making and patient management. Br J Clin Pharmacol. 2016;82(4):1076–83. Maeder MT, Konig T, Bogdanovic S, Schneider I, Eugster W, Ammann P, et al. Quality of vitamin K antagonist oral anticoagulation in 322 patients with atrial fibrillation—real-life data from a survey in Eastern Switzerland. Swiss Med Weekly. 2017;6(147):w14503. Morillas P, Pallarés V, Llisterri JL, Sanchis C, Sánchez T, Fácila L, et al. Prevalencia de fibrilación auricular y uso de fármacos antitrombóticos en el paciente hipertenso ≥ 65 años. El registro FAPRES. Rev Española Cardiol. 2010;63(08):943–50. Hwang J, Han S, Bae HJ, Jun SW, Choi SW, Lee CH, et al. NOAC adherence of patients with atrial fibrillation in the real world: dosing frequency matters? Thromb Haemost. 2020;120(2):306–13. Ozaki AF, Choi AS, Le QT, Ko DT, Han JK, Park SS, et al. Real-world adherence and persistence to direct oral anticoagulants in patients with atrial fibrillation: a systematic review and meta-analysis. Circ Cardiovasc Qual Outcomes. 2020;13(3):e005969. Piran S, Delaney J, Schulman S, Salib M, Panju M, Pai M. Direct oral anticoagulants in the real world: insights into appropriate prescribing and medication use. Can J Nurs Res. 2017;49(3):105–7.