Time in therapeutic range, quality of life and treatment satisfaction of patients on long-term warfarin for non-valvular atrial fibrillation: a cross-sectional study
Tóm tắt
The use of warfarin in patients with non-valvular atrial fibrillation (NVAF) can be challenging. In this study, we evaluate the time in therapeutic range (TTR), health-related quality of life (HRQoL) and treatment satisfaction of patients on long-term warfarin for NVAF. The HRQoL and treatment satisfaction were compared based on the TTR. A cross-sectional study was conducted among patients on warfarin for NVAF who attended the anticoagulant clinic of a tertiary cardiology referral center in Sarawak from 1st June 2018 to 31st May 2019. Patients’ TTR was calculated by using Rosendaal technique, while their HRQoL and treatment satisfaction were assessed by using Short Form 12 Health Survey version 2 (SF12v2) and Duke Anticoagulant Satisfaction Scale (DASS), respectively. A total of 300 patients were included, with mean TTR score of 47.0 ± 17.3%. The physical component summary (PCS) and mental component summary (MCS) score of SF-12v2 were 47.0 ± 9.0 and 53.5 ± 9.6, respectively. The total score for DASS was 55.2 ± 21.3, while the score for limitations (L), hassles and burdens (H&B) and positive psychological impacts (PPI) were 18.0 ± 10.0, 15.6 ± 9.1 and 21.6 ± 5.9, respectively. Seventy-three (24.3%) patients had good TTR (≥ 60%), with mean of 70.2 ± 8.7%; while 227 (75.5%) patients with poor TTR had significantly lower mean of 39.5 ± 11.9% (p = 0.006). There was no significant difference in the score of PCS (p = 0.150), MCS (p = 0.919) and each domain of SF-12v2 (p = 0.184–0.684) between good and poor TTR, except for social functioning (p = 0.019). The total DASS score was also not significantly different between group (p = 0.779). Similar non-significant difference was also reported in all the DASS sub dimensions (p = 0.502–0.699). Majority of the patients on long-term warfarin for NVAF in the current study have poor TTR. Their HRQoL and treatment satisfaction are independent of their TTR. Achieving a good TTR do not compromise the HRQoL and treatment satisfaction. Therefore, appropriate measures should be taken to optimise INR control, failing which direct oral anticoagulant therapy should be considered.
Tài liệu tham khảo
Wyndham CR. Atrial fibrillation: the most common arrhythmia. Tex Heart Inst J. 2000;27(3):257–67.
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.
Magnani JW, Wang N, Benjamin EJ, Garcia ME, Bauer DC, Butler J, et al. Atrial fibrillation and declining physical performance in older adults: the health, aging, and body composition study. Circ Arrhythm Electrophysiol. 2016;9(5):e003525.
Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22(8):983–8.
Lin HJ, Wolf PA, Benjamin EJ, Belanger AJ, D’Agostino RB. Newly diagnosed atrial fibrillation and acute stroke. Framingham Study Stroke. 1995;26(9):1527–30.
Pearce LA, Hart RG, Halperin JL. Assessment of three schemes for stratifying stroke risk in patients with nonvalvular atrial fibrillation. Am J Med. 2000;109(1):45–51.
Rahman F, Kwan GF, Benjamin EJ. Global epidemiology of atrial fibrillation. Nat Rev Cardiol. 2014;11(11):639–54.
Fauchier L, Philippart R, Clementy N, Bourguignon T, Angoulvant D, Ivanes F, et al. How to define valvular atrial fibrillation? Arch Cardiovasc Dis. 2015;108(10):530–9.
Lip GYH, Banerjee A, Boriani G, Chiang C, Fargo R, Freedman B, et al. Antithrombotic therapy for atrial fibrillation: chest guideline and expert panel report. Chest. 2018;154(5):1121–201.
White HD, Gruber M, Feyzi J, Kaatz S, Tse HF, Husted S, et al. Comparison of outcomes among patients randomized to warfarin therapy according to anticoagulant control: results from SPORTIF III and V. Arch Intern Med. 2007;167(3):239–45.
Holbrook AM, Pereira JA, Labiris R, et al. Systematic overview of warfarin and its drug and food interactions. Arch Intern Med. 2005;165(10):1095–106.
Wadelius M, Chen LY, Eriksson N, Bumpstead S, Ghori J, Wadelius C, et al. Association of warfarin dose with genes involved in its action and metabolism. Hum Genet. 2007;121(1):23–34.
Ware JE Jr, Sherbourne CD. The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Med Care. 1992;30(6):473–83.
Weaver M, Patrick DL, Markson LE, Martin D, Frederic I, Berger M. Issues in the measurement of satisfaction with treatment. Am J Manag Care. 1997;3(4):579–94.
Kravitz RL. Patients’ expectations for medical care: an expanded formulation based on review of the literature. Med Care Res Rev: MCRR. 1996;53(1):3–27.
Bartlett EE, Grayson M, Barker R, Levine DM, Golden A, Libber S. The effects of physician communications skills on patient satisfaction; recall, and adherence. J Chronic Dis. 1984;37(9):755–64.
Wang Y, Kong MC, Lee LH, Ng HJ, Ko Y. Knowledge, satisfaction, and concerns regarding warfarin therapy and their association with warfarin adherence and anticoagulation control. Thromb Res. 2014;133(4):550–4.
Balkhi B, Al-Rasheedi M, Elbur AI, Alghamadi A. Association between satisfaction with and adherence to warfarin therapy on the control of international normalized ratio: A hospital-based study in Saudi Arabia. Saudi Pharm J. 2018;26(1):145–9.
Suárez Fernández C, Castilla-Guerra L, Cantero Hinojosa J, Suriñach JM, Acosta de Bilbao F, Tamarit JJ, et al. Satisfaction with oral anticoagulants in patients with atrial fibrillation. Patient preference and adherence. 2018;12:267–74.
Charan J, Biswas T. How to calculate sample size for different study designs in medical research? Indian J Psychol Med. 2013;35(2):121–6.
Haas S, Ten Cate H, Accetta G, Angchaisuksiri P, Bassand J-P, Camm AJ, et al. Quality of Vitamin K antagonist control and 1-year outcomes in patients with atrial fibrillation: a global perspective from the GARFIELD-AF registry. PloS One. 2016;11(10):e0164076.
Rosendaal FR, Cannegieter SC, van der Meer FJ, Briët E. A method to determine the optimal intensity of oral anticoagulant therapy. Thromb Haemost. 1993;69(3):236–9.
Connolly SJ, Pogue J, Eikelboom J, Flaker G, Commerford P, Franzosi MG, et al. Benefit of oral anticoagulant over antiplatelet therapy in atrial fibrillation depends on the quality of international normalized ratio control achieved by centers and countries as measured by time in therapeutic range. Circulation. 2008;118(20):2029–37.
Ware JE, Kosinski M, Keller SD. A 12-item short-form health survey: construction of scales and preliminary tests of reliability and validity. Med Care. 1996;34(3):220–33.
Samsa G, Matchar DB, Dolor RJ, Wiklund I, Hedner E, Wygant G, et al. A new instrument for measuring anticoagulation-related quality of life: development and preliminary validation. Health and quality of life outcomes. 2004;2:22-.
Norhayati Mohd Noor, Aziz AA. Validity and reliability of the Malay version of 12-item short form health survey among postpartum mothers. Malays J Public Health Med. 2014;14(2):56–66.
Laila Mahmoud Matalqah, Radaideh K. Health-related quality of life among atrial fibrillation patients undergoing anticoagulation therapy. Epidemiol Biostat Public Health. 2018;15(1):e12763-1.
Ansell J, Hollowell J, Pengo V, Martinez-Brotons F, Caro J, Drouet L. Descriptive analysis of the process and quality of oral anticoagulation management in real-life practice in patients with chronic non-valvular atrial fibrillation: the international study of anticoagulation management (ISAM). J Thromb Thrombolysis. 2007;23(2):83–91.
Chan PH, Li WH, Hai JJ, Chan EW, Wong IC, Tse HF, et al. Time in therapeutic range and percentage of international normalized ratio in the therapeutic range as a measure of quality of anticoagulation control in patients with atrial fibrillation. Can J Cardiol. 2016;32(10):1247.e23–8.
Oh S, Kim J-S, Oh Y-S, Shin D-G, Pak H-N, Hwang G-S, et al. Quality of anticoagulation and treatment satisfaction in patients with non-valvular atrial fibrillation treated with Vitamin K antagonist: result from the Korean atrial fibrillation investigation II. J Korean Med Sci. 2018;33(49):e323-e.
Lam MPS, Cheung BMY. The pharmacogenetics of the response to warfarin in Chinese. Br J Clin Pharmacol. 2012;73(3):340–7.
van Walraven C, Jennings A, Oake N, Fergusson D, Forster AJ. Effect of study setting on anticoagulation control: a systematic review and metaregression. Chest. 2006;129(5):1155–66.
Azman AB, Sararaks S, Rugayah B, Low LL, Azian AA, Geeta S, et al. Quality of life of the Malaysian general population: results from a postal survey using the SF-36. Med J Malaysia. 2003;58(5):694–711.
Ng DL-C, Gan G-G, Chai C-S, Chee K-H, Tan K-L, Tan S-B, et al. Comparing quality of life and treatment satisfaction between patients on warfarin and direct oral anticoagulants: a cross-sectional study. Patient Preference Adherence. 2019;13:1363–73.
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 Adherence. 2018;12:79–87.
Contreras Muruaga MDM, Vivancos J, Reig G, Gonzalez A, Cardona P, Ramirez-Moreno JM, et al. 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. J Comp Eff Res. 2017;6(4):303–12.
Alegret JM, Vinolas X, Arias MA, Martinez-Rubio A, Rebollo P, Rafols C, et al. New oral anticoagulants vs 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.
De Caterina R, Brüggenjürgen B, Darius H, Köhler S, Lucerna M, Pecen L, et al. Quality of life and patient satisfaction in patients with atrial fibrillation on stable vitamin K antagonist treatment or switched to a non-vitamin K antagonist oral anticoagulant during a 1-year follow-up: A PREFER in AF Registry substudy. Arch Cardiovasc Dis. 2018;111(2):74–84.
Perino AC, Shrader P, Turakhia MP, Ansell JE, Gersh BJ, Fonarow GC, et al. Comparison of patient‐reported care satisfaction, quality of warfarin therapy, and outcomes of atrial fibrillation: findings from the ORBIT‐AF registry. J Am Heart Assoc. 2019;8(9):e011205.
Aidit S, Soh YC, Yap CS, Khan TM, Neoh CF, Shaharuddin S, et al. Effect of standardized Warfarin treatment protocol on anticoagulant effect: comparison of a Warfarin medication therapy adherence clinic with usual medical care. Front Pharmacol. 2017;8:637-.