Patient perception of anticoagulant treatment for stroke prevention (RE-SONANCE study)

Open Heart. 2020 Mar 24;7(1):e001202. doi: 10.1136/openhrt-2019-001202. eCollection 2020.

Abstract

Objective: We evaluated atrial fibrillation (AF) patients' perceptions of anticoagulation treatment with dabigatran or a vitamin K antagonist (VKA) for stroke prevention, according to accepted indications.

Methods: The RE-SONANCE observational, prospective, multicentre, international study used the validated Perception on Anticoagulant Treatment Questionnaire (PACT-Q) to assess patients with AF already taking a VKA who were switched to dabigatran (cohort A), and newly diagnosed patients initiated on either dabigatran or a VKA (cohort B). Visit 1 (V1) was at baseline, and visit 2 (V2) and visit 3 (V3) were at 30-45 and 150-210 days after baseline, respectively. Primary outcomes were treatment satisfaction and convenience in cohort A at V2 and V3 versus baseline, and in cohort B for dabigatran and a VKA at V2 and V3.

Results: The main analysis set comprised 4100 patients in cohort A and 5365 in cohort B (dabigatran: 3179; VKA: 2186). In cohort A, PACT-Q2 improved significantly (p<0.001 for all) for treatment convenience (mean change V1 vs V2=20.72; SD=21.50; V1 vs V3=24.54; SD=22.85) and treatment satisfaction (mean change V1 vs V2=17.60; SD=18.76; V1 vs V3=21.04; SD=20.24). In cohort B, mean PACT-Q2 scores at V2 and V3 were significantly higher (p<0.001 for all) for dabigatran versus a VKA for treatment convenience (V2=18.38; SE =0.51; V3=23.34; SE=0.51) and satisfaction (V2=15.88; SE=0.39; V3=19.01; SE=0.41).

Conclusions: Switching to dabigatran from long-term VKA therapy or newly initiated dabigatran is associated with improved patient treatment convenience and satisfaction compared with VKA therapy.

Keywords: atrial fibrillation; quality of care and outcomes; stroke.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Anticoagulants / administration & dosage*
  • Anticoagulants / adverse effects
  • Antithrombins / administration & dosage*
  • Antithrombins / adverse effects
  • Atrial Fibrillation / complications
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / drug therapy*
  • Dabigatran / administration & dosage*
  • Dabigatran / adverse effects
  • Drug Substitution
  • Europe
  • Female
  • Health Knowledge, Attitudes, Practice*
  • Hemorrhage / chemically induced
  • Humans
  • Israel
  • Male
  • Middle Aged
  • Patient Satisfaction*
  • Prospective Studies
  • Protective Factors
  • Risk Factors
  • Stroke / diagnosis
  • Stroke / etiology
  • Stroke / prevention & control*
  • Time Factors
  • Treatment Outcome
  • Vitamin K / antagonists & inhibitors
  • Young Adult

Substances

  • Anticoagulants
  • Antithrombins
  • Vitamin K
  • Dabigatran