Treatment Satisfaction and Health Related Quality of Life of Non-Valvular Atrial Fibrillation Patients on Long-Term Warfarin Based on Time in Therapeutic Range

• Main Author: Natasya Marliana, Abdul Malik
• Format: Thesis
• Language: English
• Published: Universiti Malaysia Sarawak 2024
• Subjects: RC Internal medicine; RT Nursing
• Online Access: http://ir.unimas.my/id/eprint/46096/1/MSc%20Natasya%20Marliana%20FMHS%20Treatment%20Satisfaction%20and%20Health-related%20Quality%20of%20Life%20of%20Non-Valvular%20Atrial%20Fibrillation.pdf; http://ir.unimas.my/id/eprint/46096/
• Institution: Universiti Malaysia Sarawak

Warfarin use in non-valvular atrial fibrillation (NVAF) poses challenges. This study evaluates patients' time in therapeutic range (TTR), treatment satisfaction, and HRQoL on long-term warfarin therapy for NVAF. Treatment satisfaction and HRQoL were compared based on TTR level. This cross-sectional study was conducted among NVAF patients on long- term warfarin attending the anticoagulant clinic of a tertiary cardiology referral centre in Sarawak from 1st June 2018 to 31st May 2019. TTR was calculated using the Rosandaal technique, and treatment satisfaction was assessed by the Duke Anticoagulation Satisfaction Scale (DASS) and HRQoL with Short Form-12 version 2 Health Survey (SF-12v2). This study includes 300 patients, with a mean TTR score of 47.0 ± 17.3%. The HRQoL components were physical component summary (PCS) and mental component summary (MCS) with scores of 47.0 ± 9.0 and 53.5 ± 9.6, respectively. The treatment satisfaction components namely, limitations (L), hassles and burdens (H&B), and positive physiological impactsِ(PPI)ِwereِ18.0ِ±ِ10.0,ِ15.6ِ±ِ9.1,ِandِ21.6ِ±ِ5.9ِrespectively.ِGoodِTTRِ(≥60%)ِpatients 24.3% (n=73) with a mean TTR of 70.2 ± 8.7%, while 227 (75.7%) patients with poor TTR with a lower mean of 39.5% ± 11.9%. There was no significant difference between good and poor TTR patients in DASS score (p=0.779). Similarly, no significant differences were found in DASS subdimensions (p=0.502-0.699). Likewise, there was also no significant difference in the score of PCS (p=0.150), MCS (p=0.919), and each domain of SF-12v2 (p=0.184-0.684) between good and poor TTR, except for social functioning (p=0.019). Most NVAF patients on long-term warfarin therapy in this study had poor TTR, but TTR levels did not influence their treatment satisfaction and HRQoL. Achieving a good TTR does not compromise treatment satisfaction and HRQoL. Thus, steps should be taken to improve INR control.