BACKGROUND: The reasons for patients to change their usual vitamin K antagonist (VKA) treatment to a direct oral anticoagulant (DOAC) are unexplored. METHOD: A random sample of 200 patients treated with VKAs for the indication of atrial fibrillation from the Thrombosis Service in Amsterdam was selected. A survey, using the treatment trade-off technique, was sent to participants. The trade-off included four scenarios: 1 (no need for laboratory controls); 2 (less bleeding); 3 (less interactions); 4 (more effective). RESULTS: Under scenario 1, 57% of the patients would have made the switch, with a further increase to 65% with scenario 2 (trend value, p = 0.006, 95% CI 1.11-1.85). In addition, in each scenario patients who were less satisfied with their current treatment were more likely to switch to a DOAC compared with satisfied patients. The variables duration of treatment, gender, age and educational level did not affect the preference for a DOAC. CONCLUSION: Patients considered no requirement for regular laboratory control and a lower risk of bleeding the most important arguments to switch to a DOAC.
BACKGROUND: The reasons for patients to change their usual vitamin K antagonist (VKA) treatment to a direct oral anticoagulant (DOAC) are unexplored. METHOD: A random sample of 200 patients treated with VKAs for the indication of atrial fibrillation from the Thrombosis Service in Amsterdam was selected. A survey, using the treatment trade-off technique, was sent to participants. The trade-off included four scenarios: 1 (no need for laboratory controls); 2 (less bleeding); 3 (less interactions); 4 (more effective). RESULTS: Under scenario 1, 57% of the patients would have made the switch, with a further increase to 65% with scenario 2 (trend value, p = 0.006, 95% CI 1.11-1.85). In addition, in each scenario patients who were less satisfied with their current treatment were more likely to switch to a DOAC compared with satisfied patients. The variables duration of treatment, gender, age and educational level did not affect the preference for a DOAC. CONCLUSION:Patients considered no requirement for regular laboratory control and a lower risk of bleeding the most important arguments to switch to a DOAC.
Authors: Austin A Robinson; Cory R Trankle; Grayson Eubanks; Christopher Schumann; Paul Thompson; Ryan L Wallace; Shouri Gottiparthi; Benjamin Ruth; Christopher M Kramer; Michael Salerno; Kenneth C Bilchick; Cody Deen; Michael C Kontos; John Dent Journal: JAMA Cardiol Date: 2020-06-01 Impact factor: 14.676
Authors: Pamela L Lutsey; Keith J Horvath; Lisa Fullam; Stephan Moll; Mary R Rooney; Mary Cushman; Neil A Zakai Journal: Thromb Haemost Date: 2018-02-15 Impact factor: 5.249
Authors: Linda P T Joosten; Sander van Doorn; Arno W Hoes; Melchior C Nierman; Nynke M Wiersma; Huiberdina L Koek; Martin E W Hemels; Menno V Huisman; Kit C Roes; Rutger M van den Bor; Wim F Buding; Frans H Rutten; Geert-Jan Geersing Journal: BMJ Open Date: 2019-12-29 Impact factor: 2.692