Clinical profile and satisfaction with anticoagulated treatment in patients with non-valvular atrial fibrillation attended in Internal Medicine and Neurology departments of Spain
AIM To determine the clinical profile, management of anticoagulant treatment and satisfaction related to anticoagulation in outpatients with nonvalvular atrial fibrillation attended in Neurology or Internal Medicine departments of Spain.
PATIENTS AND METHODS Cross-sectional and multicenter study, in which 1,337 outpatients were included. Patients fulfilled ACTS, SAT-Q and EQ-5D questionnaires.
RESULTS 865 patients (64.7%) were recruited from Neurology department and 472 (35.3%) from Internal Medicine department. Those patients attended in Internal Medicine department were older and had more frequently hypertension, diabetes, heart failure, renal insufficiency and peripheral artery disease. Those patients attended in Neurology department had more commonly prior stroke. Overall, CHADS2 score was 3.2 ± 1.3, CHA2DS2-Vasc 4.8 ± 1.5 and HAS-BLED 2.0 ± 0.9. All scores were higher in those patients attended in Neurology department. Globally, 56.1% of patients were taking vitamin K antagonists, more commonly in Internal Medicine department. The adequate percent of time in therapeutic range was 47% (Rosendaal), without significant differences between groups. Satisfaction with oral anticoagulation was high in both groups, but higher in those attended in Neurology department, and higher in those individuals taking direct oral anticoagulants compared with vitamin K antagonists.
CONCLUSIONS Although there were some differences in the clinical profile of patients with atrial fibrillation attended in Neurology or Internal Medicine departments, all of them had many comorbidities and a high thromboembolic risk. Despite INR control was poor, the most common oral anticoagulant used were vitamin K antagonists. Satisfaction related to oral anticoagulation was high.KeywordsAnticoagulationAtrial fibrillationInternal medicineNeurologyQuality of lifeSatisfactionCategoriesCalidad, Gestión y Organización Asistencial
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