Journal of Korean Medical Science

Korean Acad Medical Sciences (대한의학회)
권호 표지
DOI QR코드

DOI QR Code

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

  • Oh, Seil (Department of Internal Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Kim, June-Soo (Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine) ;
  • Oh, Yong-Seog (Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Shin, Dong-Gu (Department of Internal Medicine, Yeungnam University Hospital, Yeungnam University College of Medicine) ;
  • Pak, Hui-Nam (Department of Internal Medicine, Severance Hospital, Yonsei University Health System) ;
  • Hwang, Gyo-Seung (Department of Internal Medicine, Ajou University Hospital) ;
  • Choi, Kee-Joon (Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Jin-Bae (Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University School of Medicine) ;
  • Lee, Man-Young (Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea) ;
  • Park, Hyung-Wook (Department of Internal Medicine, Chonnam National University Hospital) ;
  • Kim, Dae-Kyeong (Department of Internal Medicine, Busan Paik Hospital, Inje University College of Medicine) ;
  • Jin, Eun-Sun (Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine) ;
  • Park, Jaeseok (Department of Internal Medicine, Sejong General Hospital) ;
  • Oh, Il-Young (Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Shin, Dae-Hee (Department of Internal Medicine, Gangneung Asan Hospital) ;
  • Park, Hyoung-Seob (Department of Internal Medicine, Keimyung University Dongsan Medical Center, Keimyung University College of Medicine) ;
  • Kim, Jun Hyung (Department of Internal Medicine, Chungnam National University College of Medicine) ;
  • Kim, Nam-Ho (Department of Internal Medicine, Wonkwang University Hospital) ;
  • Ahn, Min-Soo (Department of Internal Medicine, Yonsei University, Wonju Severance Christian Hospital) ;
  • Seo, Bo-Jeong (Outcomes Research/Real World Data, Corporate Affairs & Health and Value, Pfizer Pharmaceuticals Korea Ltd.) ;
  • Kim, Young-Joo (Outcomes Research/Real World Data, Corporate Affairs & Health and Value, Pfizer Pharmaceuticals Korea Ltd.) ;
  • Kang, Seongsik (Department of Internal Medicine-Medical, Pfizer Pharmaceuticals Korea Ltd.) ;
  • Lee, Juneyoung (Department of Biostatistics, Korea University College of Medicine) ;
  • Kim, Young-Hoon (Department of Internal Medicine, Korea University College of Medicine)
  • Received : 2018.05.01
  • Accepted : 2018.08.07
  • Published : 2018.12.03
⟨ Previous Next ⟩

Abstract

Background: Vitamin K antagonist (VKA) to prevent thromboembolism in non-valvular atrial fibrillation (NVAF) patients has limitations such as drug interaction. This study investigated the clinical characteristics of Korean patients treated with VKA for stroke prevention and assessed quality of VKA therapy and treatment satisfaction. Methods: We conducted a multicenter, prospective, non-interventional study. Patients with $CHADS_2{\geq}1$ and treated with VKA (started within the last 3 months) were enrolled from April 2013 to March 2014. Demographic and clinical features including risk factors of stroke and VKA treatment information was collected at baseline. Treatment patterns and international normalized ratio (INR) level were evaluated during follow-up. Time in therapeutic range (TTR) > 60% indicated well-controlled INR. Treatment satisfaction on the VKA use was measured by Treatment Satisfaction Questionnaire for Medication (TSQM) after 3 months of follow-up. Results: A total of 877 patients (age, 67; male, 60%) were enrolled and followed up for one year. More than half of patients (56%) had $CHADS_2{\geq}2$ and 83.6% had $CHA_2DS_2-VASc{\geq}2$. A total of 852 patients had one or more INR measurement during their follow-up period. Among those patients, 25.5% discontinued VKA treatment during follow-up. Of all patients, 626 patients (73%) had poor-controlled INR (TTR < 60%) measure. Patients' treatment satisfaction measured with TSQM was 55.6 in global satisfaction domain. Conclusion: INR was poorly controlled in Korean NVAF patients treated with VKA. VKA users also showed low treatment satisfaction.

Keywords

Acknowledgement

Supported by : BMS/Pfizer Pharmaceuticals Korea Ltd.

References

  1. Jeong JH. Prevalence of and risk factors for atrial fibrillation in Korean adults older than 40 years. J Korean Med Sci 2005;20(1):26-30. https://doi.org/10.3346/jkms.2005.20.1.26
  2. Marinigh R, Lip GY, Fiotti N, Giansante C, Lane DA. Age as a risk factor for stroke in atrial fibrillation patients: implications for thromboprophylaxis. J Am Coll Cardiol 2010;56(11):827-37. https://doi.org/10.1016/j.jacc.2010.05.028
  3. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA 2001;285(18):2370-5. https://doi.org/10.1001/jama.285.18.2370
  4. Diringer MN, Edwards DF, Mattson DT, Akins PT, Sheedy CW, Hsu CY, et al. Predictors of acute hospital costs for treatment of ischemic stroke in an academic center. Stroke 1999;30(4):724-8. https://doi.org/10.1161/01.STR.30.4.724
  5. Dulli DA, Stanko H, Levine RL. Atrial fibrillation is associated with severe acute ischemic stroke. Neuroepidemiology 2003;22(2):118-23. https://doi.org/10.1159/000068743
  6. Slot KB, Berge E, Dorman P, Lewis S, Dennis M, Sandercock P, et al. Impact of functional status at six months on long term survival in patients with ischaemic stroke: prospective cohort studies. BMJ 2008;336(7640):376-9. https://doi.org/10.1136/bmj.39456.688333.BE
  7. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the Heart Rhythm Society. J Am Coll Cardiol 2014;64(21):e1-76. https://doi.org/10.1016/j.jacc.2014.03.022
  8. Ogilvie IM, Newton N, Welner SA, Cowell W, Lip GY. Underuse of oral anticoagulants in atrial fibrillation: a systematic review. Am J Med 2010;123(7):638-645.e4. https://doi.org/10.1016/j.amjmed.2009.11.025
  9. Lip GY, Agnelli G, Thach AA, Knight E, Rost D, Tangelder MJ. Oral anticoagulation in atrial fibrillation: A pan-European patient survey. Eur J Intern Med 2007;18(3):202-8. https://doi.org/10.1016/j.ejim.2006.11.005
  10. Shin HW, Kim YN, Bae HJ, Lee HM, Cho HO, Cho YK, et al. Trends in oral anticoagulation therapy among Korean patients with atrial fibrillation: the Korean atrial fibrillation investigation. Korean Circ J 2012;42(2):113-7. https://doi.org/10.4070/kcj.2012.42.2.113
  11. Witt DM, Delate T, Clark NP, Martell C, Tran T, Crowther MA, et al. Outcomes and predictors of very stable INR control during chronic anticoagulation therapy. Blood 2009;114(5):952-6. https://doi.org/10.1182/blood-2009-02-207928
  12. Reynolds MR, Shah J, Essebag V, Olshansky B, Friedman PA, Hadjis T, et al. Patterns and predictors of warfarin use in patients with new-onset atrial fibrillation from the FRACTAL Registry. Am J Cardiol 2006;97(4):538-43. https://doi.org/10.1016/j.amjcard.2005.09.086
  13. NCSS. 2008. NCSS, LLC. https://www.ncss.com/. Updated 2012. Accessed December 10, 2012.
  14. Fleiss JL, Levin B, Paik MC. An introduction to applied probability. In: Shewart WA, Wilks SS, editors. Statistical Methods for Rates and Proportions. Hoboken, NJ: John Wiley & Sons, Inc.; 2004, 17-49.
  15. Newcombe RG. Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med 1998;17(8):857-72. https://doi.org/10.1002/(SICI)1097-0258(19980430)17:8<857::AID-SIM777>3.0.CO;2-E
  16. Admassie E, Chalmers L, Bereznicki LR. Changes in oral anticoagulant prescribing for stroke prevention in patients with atrial fibrillation. Am J Cardiol 2017;120(7):1133-8. https://doi.org/10.1016/j.amjcard.2017.06.055
  17. Haas S, Ten Cate H, Accetta G, Angchaisuksiri P, Bassand JP, 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. https://doi.org/10.1371/journal.pone.0164076
  18. Oh S, Goto S, Accetta G, Angchaisuksiri P, Camm AJ, Cools F, et al. Vitamin K antagonist control in patients with atrial fibrillation in Asia compared with other regions of the world: real-world data from the GARFIELD-AF registry. Int J Cardiol 2016;223:543-7. https://doi.org/10.1016/j.ijcard.2016.08.236
  19. Kim TH, Yang PS, Kim D, Yu HT, Uhm JS, Kim JY, et al. CHA2DS2-VASc score for identifying truly low-risk atrial fibrillation for stroke: a Korean nationwide cohort study. Stroke 2017;48(11):2984-90. https://doi.org/10.1161/STROKEAHA.117.018551
  20. Al-Jabi SW, Zyoud SH, Sweileh WM, Wildali AH, Saleem HM, Aysa HA, et al. Relationship of treatment satisfaction to health-related quality of life: findings from a cross-sectional survey among hypertensive patients in Palestine. Health Expect 2015;18(6):3336-48. https://doi.org/10.1111/hex.12324
  21. Sweileh WM, Ihbesheh MS, Jarar IS, Taha AS, Sawalha AF, Zyoud SH, et al. Self-reported medication adherence and treatment satisfaction in patients with epilepsy. Epilepsy Behav 2011;21(3):301-5. https://doi.org/10.1016/j.yebeh.2011.04.011
  22. Liberato AC, Rodrigues RC, Sao-Joao TM, Alexandre NM, Gallani MC. Satisfaction with medication in coronary disease treatment: psychometrics of the treatment satisfaction questionnaire for medication. Rev Lat Am Enfermagem 2016;24:e2705.
  23. Kakkar AK, Mueller I, Bassand JP, Fitzmaurice DA, Goldhaber SZ, Goto S, et al. Risk profiles and antithrombotic treatment of patients newly diagnosed with atrial fibrillation at risk of stroke: perspectives from the international, observational, prospective GARFIELD registry. PLoS One 2013;8(5):e63479. https://doi.org/10.1371/journal.pone.0063479
  24. Tulner LR, Van Campen JP, Kuper IM, Gijsen GJ, Koks CH, Mac Gillavry MR, et al. Reasons for undertreatment with oral anticoagulants in frail geriatric outpatients with atrial fibrillation: a prospective, descriptive study. Drugs Aging 2010;27(1):39-50. https://doi.org/10.2165/11319540-000000000-00000
  25. Bungard TJ, Ghali WA, Teo KK, McAlister FA, Tsuyuki RT. Why do patients with atrial fibrillation not receive warfarin? Arch Intern Med 2000;160(1):41-6. https://doi.org/10.1001/archinte.160.1.41
  26. Sudlow M, Thomson R, Thwaites B, Rodgers H, Kenny RA. Prevalence of atrial fibrillation and eligibility for anticoagulants in the community. Lancet 1998;352(9135):1167-71. https://doi.org/10.1016/S0140-6736(98)01401-9
  27. Lip GY, Golding DJ, Nazir M, Beevers DG, Child DL, Fletcher RI. A survey of atrial fibrillation in general practice: the West Birmingham Atrial Fibrillation Project. Br J Gen Pract 1997;47(418):285-9.
  28. Kirchhof P, Benussi S, Kotecha D, Ahlsson A, Atar D, Casadei B, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016;37(38):2893-962. https://doi.org/10.1093/eurheartj/ehw210
  29. January CT, Wann LS, Alpert JS, Calkins H, Cigarroa JE, Cleveland JC Jr, et al. 2014 AHA/ACC/HRS guideline for the management of patients with atrial fibrillation: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the Heart Rhythm Society. Circulation 2014;130(23):2071-104. https://doi.org/10.1161/CIR.0000000000000040
  30. Bajorek BV, Ogle SJ, Duguid MJ, Shenfield GM, Krass I. Balancing risk versus benefit: the elderly patient's perspective on warfarin therapy. Pharm Pract (Granada) 2009;7(2):113-23.
  31. Wild D, Murray M, Donatti C. Patient perspectives on taking vitamin K antagonists: a qualitative study in the UK, USA and Spain. Expert Rev Pharmacoecon Outcomes Res 2009;9(5):467-74. https://doi.org/10.1586/erp.09.48
  32. Dantas GC, Thompson BV, Manson JA, Tracy CS, Upshur RE. Patients' perspectives on taking warfarin: qualitative study in family practice. BMC Fam Pract 2004;5(1):15. https://doi.org/10.1186/1471-2296-5-15
  33. De Caterina R, Bruggenjurgen B, Darius H, Kohler 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. https://doi.org/10.1016/j.acvd.2017.04.007

Cited by

  1. Patients’ and parents’ satisfaction with, and preference for, haemophilia A treatments: a cross‐sectional, multicentre, observational study vol.27, pp.4, 2018, https://doi.org/10.1111/hae.14304
  2. Impact of Reduced-Dose Nonvitamin K Antagonist Oral Anticoagulants on Outcomes Compared to Warfarin in Korean Patients with Atrial Fibrillation: A Nationwide Population-Based Study vol.10, pp.17, 2018, https://doi.org/10.3390/jcm10173918