Satisfaction, quality of life and therapy adherence assessment in real life patients transitioning from vitamin K antago
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Satisfaction, quality of life and therapy adherence assessment in real life patients transitioning from vitamin K antagonists to direct oral anticoagulants Alessandra Serrao1 · Benedetta Lucani1 · Giovanni Assanto Manfredi1 · Luciano Fiori1 · Erminia Baldacci1 · Simona Michela Aprile1 · Antonio Chistolini1
© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Anticoagulant therapy has undergone a significant change since direct oral anticoagulants (DOACs) introduction. Their obvious advantages including the fixed dose, the few interactions and less frequent controls, have made them the first choice anticoagulant therapy. More and more patients have therefore switched from therapy with vitamin K antagonists (VKAs) to DOACs. Aim of our study was to assess the satisfaction, quality of life (QoL) and therapy adherence of patients who switched from VKA to DOACs therapy. This single center study evaluated satisfaction and QoL of 107 patients who switched from VKA to DOACs therapy through Anti-Clot Treatment Scale and SF-36 respectively. The questionnaires were administered before therapy change, after 3 months of DOACs therapy and then annually. We also evaluated DOACs therapy adherence with a questionnaire administered each visit and through the measures of DOACs plasma levels. Patients’ satisfaction and QoL were high during VKA therapy, but with DOACs we observed an improvement after the first 3 months and then maintained over the time of DOACs therapy. DOACs adherence was excellent, also confirmed by DOACs plasma levels.
Highlights • Anticoagulation therapy with vitamin K antagonists had
been for ages the only anticoagulant treatment.
• Direct oral anticoagulants proved to have the same effi-
cacy of vitamin K antagonists with a better safety profile.
• More and more patients transitioned from traditional anti-
coagulant therapy to direct oral anticoagulants: patients’ satisfaction, quality of life were high during vitamin K antagonists therapy, but with during direct oral anticoagulants an improvement was observed. • Monitoring direct oral anticoagulants plasma level can be helpful in assess therapy adherence.
* Antonio Chistolini [email protected] 1
“Sapienza”, University of Rome, Via Benevento 6, 00161 Rome, Italy
Introduction Anticoagulation therapy with vitamin K antagonists (VKAs) had been for ages the only anticoagulant treatment for atrial fibrillation (AF) and for venous thromboembolism (VTE). Their mechanism of action makes easy to monitor their anticoagulant effect through the international normalized ratio (INR) in order to adjust therapy dose [1]. In order to guarantee an optimal therapeutic efficacy, the time in therapeutic range (TTR) should be ≥ 70%, but the proportion of patients out of the ideal therapeutic range of the INR is still between 32 and 47% [2]. Direct oral anticoagulants (DOACs) proved to have the same efficacy of VKAs with a better safety profile, emerging as innovative drugs with a predictable and stable pharmacokinetics that avoids the
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