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DOI: 10.1055/s-0038-1670661
Patient-Reported Treatment Satisfaction with Dabigatran versus Warfarin in Patients with Non-Valvular Atrial Fibrillation in China
Funding This work was supported by the National Key Research and Development Program of China (2016YFC0900901, 2016YFC1301002), a grant from the National Science Foundation of China (81530016) and grants from the Beijing Municipal Commission of Science and Technology (D151100002215003, D151100002215004). The construction of the China-AF was also supported by grants from BMS, Pfizer, Johnson & Johnson, BI and Bayer.Publikationsverlauf
03. November 2017
08. August 2018
Publikationsdatum:
20. September 2018 (online)
![](https://www.thieme-connect.de/media/10.1055-s-00035024/201810/lookinside/thumbnails/10-1055-s-0038-1670661_170772-1.jpg)
Abstract
Background Anti-coagulant therapy satisfaction for patients with atrial fibrillation is a critical issue, which impacts on their treatment adherence and clinical outcomes. The disadvantages of long-term warfarin treatment are well-described, and novel oral anti-coagulants have become an alternative option.
Materials and Methods We compared patient-reported treatment satisfaction with dabigatran versus warfarin in non-valvular atrial fibrillation (NVAF) patients in China. Treatment satisfaction was assessed using the Anti-Clot Treatment Scale (ACTS) questionnaire, which included a 12-item ACTS Burdens scale and a 3-item ACTS Benefits scale.
Results Among 834 patients, 246 patients (29.5%) were taking dabigatran and the others were on warfarin. Propensity score matching was employed to identify 182 patient pairs with balanced baseline characteristics. The global ACTS Burdens score and the global ACTS Benefits score were comparable between the dabigatran and warfarin groups (44.86 ± 3.95 vs. 44.28 ± 3.51, p = 0.423; 11.49 ± 2.92 vs. 11.42 ± 3.03, p = 0.194, respectively). The monthly cost of dabigatran was significantly higher compared with that of warfarin due to a lack of insurance coverage (USD 176.78 ± 9.15 vs. USD 2.49 ± 0.76, p = 0.000). The discontinuation rate of dabigatran was significantly higher than warfarin at the 6-month follow-up (33.5% vs. 19.2%, p = 0.003). Adjusted logistic regression showed that dabigatran was associated with a significant greater odds of non-persistence (odds ratio: 2.13, 95% confidence interval: 1.27–3.59, p = 0.004).
Conclusion Dabigatran therapy in patients with NVAF in China associated with no improvement in satisfaction and a higher discontinuation rate compared with warfarin therapy largely due to increased economic burden.
Keywords
non-valvular atrial fibrillation - dabigatran - warfarin - anti-clot treatment scale - treatment satisfaction-
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