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Patient Satisfaction With Warfarin- and Non–Warfarin-Containing Thromboprophylaxis Regimens for Atrial Fibrillation
  1. Craig I. Coleman, PharmD*,
  2. Stacey M. Coleman, BSN, RN,
  3. Julie Vanderpoel, PharmD,
  4. Winnie Nelson, PharmD,
  5. Jennifer A. Colby, PharmD*,
  6. Jennifer M. Scholle, PharmD*,
  7. Jeffrey Kluger, MD
  1. From the *University of Connecticut School of Pharmacy, Storrs; †Department of Cardiology, Hartford Hospital, Hartford, CT; ‡Janssen Scientific Affairs, LLC, Raritan, NJ.
  1. Received November 21, 2012, and in revised form February 14, 2013.
  2. Accepted for publication February 14, 2013.
  3. Reprints: Craig I. Coleman, PharmD, University of Connecticut School of Pharmacy, 80 Seymour St, Hartford, CT 06102-5037. E-mail: ccolema{at}harthosp.org.

Abstract

Objective To compare patient-reported limitations, concerns, and burdens in those receiving and not receiving warfarin for thromboprophylaxis in atrial fibrillation (AF).

Methods We conducted a cross-sectional survey study of patients with AF receiving thromboprophylaxis for stroke prevention. Patients were administered the validated Anti-Clot Treatment Scale (ACTS). Mean scores of patients receiving and not receiving warfarin were compared for each ACTS item, and for the Burden and Benefit subscales.

Results From July 2010 to August 2011, 80 patients with AF were administered the survey, with 65 patients receiving a regimen containing warfarin and 15 patients not receiving a regimen containing warfarin. Six of the 17 individual questions depicting patient- perceived limitations in physical activity due to bleeding, limitations on diet, feelings of inconvenience of occasional aspects of thromboprophylaxis therapy, and frustration, and burden had less favorable scores in the warfarin-managed patients compared with the patients not receiving warfarin (P < 0.05 for all). Mean ACTS Burden scores were more favorable in the no-warfarin group (44.5 ± 6.4) compared with the warfarin group (39.8 ± 8.0; P = 0.003). No difference was seen between the 2 groups on the ACTS Benefits score (11.1 ± 3.4 vs 10.4 ± 3.7; P = 0.38).

Conclusion Patients with AF receiving warfarin may have less favorable feelings regarding thromboprophylaxis versus those receiving non-warfarin thromboprophylaxis. Patients report having more limitations and having greater feelings of burden on warfarin.

Key Words
  • atrial fibrillation
  • anticoagulation
  • patient-reported outcomes
  • patient satisfaction

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