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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

Background: 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 tre...

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Main Authors: Ng, Diana Leh-Ching, Asri, Said, Chai, Chee Shee
Format: Article
Language:English
Published: Springer Nature 2020
Subjects:
R Medicine (General)
RZ Other systems of medicine
Online Access:http://ir.unimas.my/id/eprint/32324/1/Diana%20Leh.pdf
http://ir.unimas.my/id/eprint/32324/
https://hqlo.biomedcentral.com/articles/10.1186/s12955-020-01600-z?utm_source=other&utm_medium=other&utm_content=null&utm_campaign=BSCN_2_DD01_CN_bmcso_article_paid_XMOL
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spelling my.unimas.ir.323242021-04-05T04:01:04Z http://ir.unimas.my/id/eprint/32324/ 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 Ng, Diana Leh-Ching Asri, Said Chai, Chee Shee R Medicine (General) RZ Other systems of medicine Background: 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. Methods: 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. Results: 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). Conclusions: 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. Springer Nature 2020-10-20 Article PeerReviewed text en http://ir.unimas.my/id/eprint/32324/1/Diana%20Leh.pdf Ng, Diana Leh-Ching and Asri, Said and Chai, Chee Shee (2020) 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. Health and Quality of Life Outcomes, 18 (347). pp. 1-9. ISSN 1477-7525 https://hqlo.biomedcentral.com/articles/10.1186/s12955-020-01600-z?utm_source=other&utm_medium=other&utm_content=null&utm_campaign=BSCN_2_DD01_CN_bmcso_article_paid_XMOL DOI:org/10.1186/s12955-020-01600-z
institution Universiti Malaysia Sarawak
building Centre for Academic Information Services (CAIS)
collection Institutional Repository
continent Asia
country Malaysia
content_provider Universiti Malaysia Sarawak
content_source UNIMAS Institutional Repository
url_provider http://ir.unimas.my/
language English
topic R Medicine (General)
RZ Other systems of medicine
spellingShingle R Medicine (General)
RZ Other systems of medicine
Ng, Diana Leh-Ching
Asri, Said
Chai, Chee Shee
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
description Background: 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. Methods: 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. Results: 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). Conclusions: 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.
format Article
author Ng, Diana Leh-Ching
Asri, Said
Chai, Chee Shee
author_facet Ng, Diana Leh-Ching
Asri, Said
Chai, Chee Shee
author_sort Ng, Diana Leh-Ching
title 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
title_short 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
title_full 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
title_fullStr 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
title_full_unstemmed 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
title_sort 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
publisher Springer Nature
publishDate 2020
url http://ir.unimas.my/id/eprint/32324/1/Diana%20Leh.pdf
http://ir.unimas.my/id/eprint/32324/
https://hqlo.biomedcentral.com/articles/10.1186/s12955-020-01600-z?utm_source=other&utm_medium=other&utm_content=null&utm_campaign=BSCN_2_DD01_CN_bmcso_article_paid_XMOL
_version_ 1696979528181612544
score 13.211869

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