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Quality of life decreases seen with long-term anticoagulation; patients show adaptability
Patients receiving long-term warfarin therapy may experience a reduction in quality of life, but they appear to adjust to anticoagulation-related lifestyle limitations, according to research published in Public Health.
Syed Shahzad Hasan, PhD, of The University of Queensland, Australia, and colleagues from other institutions used information collected from the Duke Anticoagulation Satisfaction Scale (DASS) and the Short Form Health Survey (SF-12) to examine relationships between quality of life and International Normalized Ratio (INR) control.
“These patients appeared to adapt well to lifestyle limitations imposed by long-term anticoagulation where patients did not experience significant limitation on their daily life specifically due to bleeding or bruising,” the researchers wrote. “Patients felt occasional hassles as more inconvenient than daily hassles.”
The researchers analyzed data on 326 outpatients (43% aged 50-64 years; 51% female) at urban anticoagulation clinics in Malaysia who were treated with warfarin for at least 1 year; half were in the DASS group and half in the SF-12 group.
The team assessed quality of life at the start of study, then again at 6 months and 1 year of treatment. The investigators recorded indications and target INR ranges, along with patients’ INR values. Time spent in therapeutic range was estimated for four subgroups, based on INR target ranges for specific indications.
DASS-assessed patients older than 35 years demonstrated significant decreases in overall mean quality of life scores related to anticoagulation; however, patients assessed with SF-12 perceived increases in quality of life.
For all INR target range subgroups, the mean percentage for days in range was not higher than 60%. A weak correlation was observed between INR control and overall quality of life (P > .05).
“The finding of a different [quality of life] perception in the lowest age stratum is interesting and should warrant further exploration to what extent this could be an attitude phenomenon, or just reflects age-related differences in spectrum of diseases with varying impact on [quality of life],” the researchers wrote. – by Allegra Tiver
Disclosures: The researchers report no relevant financial disclosures.