Patient-Reported Treatment Satisfaction with Dabigatran versus Warfarin in Patients with Non-Valvular Atrial Fibrillation in China.

Abstract

BACKGROUND:

 Anti-coagulant therapy satisfaction for patients with atrial fibrillation is a critical issue, which impacts on their treatment adherence and clinical outcomes. The disadvantages of long-term warfarin treatment are well-described, and novel oral anti-coagulants have become an alternative option.

MATERIALS AND METHODS:

 We compared patient-reported treatment satisfaction with dabigatran versus warfarin in non-valvular atrial fibrillation (NVAF) patients in China. Treatment satisfaction was assessed using the Anti-Clot Treatment Scale (ACTS) questionnaire, which included a 12-item ACTS Burdens scale and a 3-item ACTS Benefits scale.

RESULTS:

 Among 834 patients, 246 patients (29.5%) were taking dabigatran and the others were on warfarin. Propensity score matching was employed to identify 182 patient pairs with balanced baseline characteristics. The global ACTS Burdens score and the global ACTS Benefits score were comparable between the dabigatran and warfarin groups (44.86 ± 3.95 vs. 44.28 ± 3.51, p = 0.423; 11.49 ± 2.92 vs. 11.42 ± 3.03, p = 0.194, respectively). The monthly cost of dabigatran was significantly higher compared with that of warfarin due to a lack of insurance coverage (USD 176.78 ± 9.15 vs. USD 2.49 ± 0.76, p = 0.000). The discontinuation rate of dabigatran was significantly higher than warfarin at the 6-month follow-up (33.5% vs. 19.2%, p = 0.003). Adjusted logistic regression showed that dabigatran was associated with a significant greater odds of non-persistence (odds ratio: 2.13, 95% confidence interval: 1.27-3.59, p = 0.004).

CONCLUSION:

 Dabigatran therapy in patients with NVAF in China associated with no improvement in satisfaction and a higher discontinuation rate compared with warfarin therapy largely due to increased economic burden.

• Authors: Yan-Ping Geng, Di-Hui Lan, Nian Liu, Xin Du, Danni Zheng, Ri-Bo Tang, De-Yong Long, Rong-Hui Yu, Cai-Hua Sang, Rong Bai, Chen-Xi Jiang, Song-Nan Li, Xue-Yuan Guo, Wei Wang, Shi-Jun Xia, San-Shuai Chang, Jian-Zeng Dong, Ai-Hua Chen, Chang-Sheng Ma
• Journal: Thrombosis and haemostasis (Thromb Haemost) Vol. 118 Issue 10 Pg. 1815-1822 (Oct 2018) ISSN: 2567-689X [Electronic] Germany
• PMID: 30235486 (Publication Type: Comparative Study, Journal Article)
• Copyright: Georg Thieme Verlag KG Stuttgart · New York.

Chemical References

• Anticoagulants
• Warfarin
• Dabigatran

Topics

• Aged
• Aged, 80 and over
• Anticoagulants (therapeutic use)
• Atrial Fibrillation (drug therapy, epidemiology)
• China (epidemiology)
• Costs and Cost Analysis
• Dabigatran (therapeutic use)
• Female
• Humans
• Male
• Medication Adherence
• Middle Aged
• Patient Outcome Assessment
• Patient Satisfaction
• Self Report
• Surveys and Questionnaires
• Warfarin (therapeutic use)