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Original research
Real-world evaluation of perception, convenience and anticoagulant treatment satisfaction of patients with atrial fibrillation switched from long-term vitamin K antagonist treatment to dabigatran
  1. Eue-Keun Choi1,
  2. Young-Soo Lee2,
  3. Alan Koay Choon Chern3,
  4. Panyapat Jiampo4,
  5. Aurauma Chutinet5,
  6. Dicky Armein Hanafy6,
  7. Prabhav Trivedi7,
  8. Dongmei Zhai8 and
  9. Yong Seog Oh9
  1. 1Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea (the Republic of)
  2. 2Department of Internal Medicine, Daegu Catholic University College of Medicine, Daegu, Korea (the Republic of)
  3. 3Department of Cardiology, National Heart Institute, Kuala Lumpur, Malaysia
  4. 4Department of Medicine, Bhumibol Adulyadej Hospital, Bangkok, Thailand
  5. 5Chulalongkorn Stroke Center, King Chulalongkorn Memorial Hospital, Thai Red Cross Society and Faculty of Medicine, Bangkok, Thailand
  6. 6Department of Cardiology and Vascular Medicine, National Cardiovascular Center Harapan Kita, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia
  7. 7Department of Medical Affairs, Boehringer Ingelheim GmBH, Ingelheim am Rhein, Germany
  8. 8Department of Statistics, Boehringer Ingelheim Pharmaceuticals Inc, Ridgefield, Connecticut, USA
  9. 9Department of Internal of Medicine, Catholic University of Korea, Seoul, Korea (the Republic of)
  1. Correspondence to Professor Eue-Keun Choi; choiek417{at}gmail.com

Abstract

Background and purpose Real-world data about treatment convenience and satisfaction in Asian non-valvular atrial fibrillation (NVAF) patients after switching from vitamin K antagonists (VKAs) to non-VKA oral anticoagulants were evaluated.

Methods In this non-interventional study involving 49 sites across five countries in Southeast Asia and South Korea, 379 stable NVAF patients who switched from VKA therapy to dabigatran during routine clinical practice were recruited and followed up for 6 months. Treatment convenience and satisfaction were evaluated using Perception on Anticoagulant Treatment Questionnaire-2 (PACT-Q2). Through post hoc analysis, factors associated with improved treatment convenience scores at visit 2 were described.

Results Treatment convenience and satisfaction significantly improved after switching from VKAs to dabigatran at visit 2 and visit 3 (convenience: p<0.001 each vs baseline; satisfaction: p=0.0174 (visit 2), p=0.0004 (visit 3) compared with baseline). Factors predictive of higher (>80th percentile) response on treatment convenience were female sex, younger age (<75 years), higher baseline stroke risk, higher creatinine clearance and absence of concomitant hypertension, stroke or gastrointestinal diseases.

Conclusion Dabigatran was associated with a significant improvement in treatment convenience and satisfaction after switching from VKAs when used for stroke prevention in NVAF patients from Southeast Asia and South Korea.

  • stroke
  • atrial fibrillation
  • anticoagulation
  • oral anticoagulants
  • quality of care and outcomes
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Footnotes

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  • Contributors E-KC: Substantial contributions to the conception and design of the work, acquisition of data, analysis and interpretation of data, revising the work critically for important intellectual content. Y-SL: Substantial contributions to the conception and design of the work, acquisition of data, analysis and interpretation of data. AKCC: Substantial contributions to the acquisition of data, analysis and interpretation of data. PJ: Substantial contributions to the acquisition of data, analysis and interpretation of data. AC: Substantial contributions to the acquisition of data, analysis and interpretation of data. DAH: Substantial contributions to the acquisition of data, analysis and interpretation of data. PT: Substantial contributions to the conception and design of the work, analysis and interpretation of data, and having the work drafted and revised. DZ: Substantial contributions to the analysis and interpretation of data, and having the work drafted and revised. YSO: Substantial contributions to the conception and design of the work, acquisition of data, analysis and interpretation of data. All authors have approved the submitted version. All authors have agreed to be personally accountable for the work, and to ensure that questions related to the accuracy or integrity of any part of the work (even ones in which the authors were not personally involved) are appropriately investigated, resolved, and the resolution documented in the literature.

  • Funding Financial support for the conduct of this study and the preparation of this manuscript was provided by Boehringer Ingelheim.

  • Competing interests E-KC has received modest research support from Daiichi-Sankyo, BMS/Pfizer and Biosense Webster, unrelating to the current study. Y-SL reports no conflicts of interest relating to the current study. AKCC reports no conflicts of interest relating to the current study. Panyapat Jiampo has received modest research grants and honoraria from Boehringer Ingelheim, relating to the current study. AC has received modest research grants and honoraria from Boehringer Ingelheim, relating to the current study. DAH has received modest research grants and honoraria from Boehringer Ingelheim, relating to the current study. PT and DZ are employees of Boehringer Ingelheim. YSO has received significant research grants from Daiichi-Sankyo and Boehringer Ingelheim, relating to the current study.

  • Patient consent for publication Not required.

  • Ethics approval The study protocol was approved by the institutional review boards (IRBs) of each individual centre (49 centres across 5 countries in the South East Asian Region; Indonesia: 2 centres, Malaysia: 5 centres, Singapore: 3 centres, South Korea: 33 centres and Thailand: 6 centres), with the exception of Singapore where the Centralised Institutional Review Board (Domain C) approved the protocol for all the three participating centres. The detailed list of all the involved centres and IRBs is available from the corresponding author on reasonable request. All the study participants fitting the inclusion criteria were administered written informed consent prior to the initiation of the study.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement The datasets used and/or analysed during the current study are available from the corresponding author on reasonable request.

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