Abstract 240: Survey of Patients With Atrial Fibrillation on the Use of Warfarin and the Newer Anticoagulant, Dabigatran

Abstract

BACKGROUND: In 2010 and 2011, U.S. atrial fibrillation (AF) patients had two choices for oral anticoagulation therapy. However, limited real world data exist as to the patient characteristics, usage patterns, and medication perceptions of patients on these newer treatments. OBJECTIVE: To describe and compare characteristics of AF patients who have used warfarin or the newer anticoagulant, dabigatran. METHODS: Patient surveys were conducted via phone or internet from September 2011 to November 2011. Study patients were ≥18 years old, had a diagnosis of AF, and have used either warfarin or the newer anticoagulant, dabigatran. Characteristics differences were tested using chi-squared and ANOVA for categorical and continuous variables, respectively. RESULTS: We surveyed 361 patients. Of those, 204 were warfarin users and 160 were newer anticoagulant users (NAU). Mean patient age was 65.1. Patients were predominantly male (68.7%) and non-Hispanic white (91.2%). Nearly half (44.0%) of patients were obese and more than half (58.0%) had a Charlson Comorbidity Index (CCI) of ≥1. Average number of years with an AF diagnosis was 7. Patients were taking 6.26 medications on average. NAU were more likely to be female (36.9% vs. 27.0%), younger (60.93 vs. 68.36 years), diagnosed more recently (5.78 vs. 8.10 years), and had more education compared to warfarin patients (all p<.05). Levels of obesity (31.9% vs. 53.4%) and CCI burden of ≥1 (51.9% vs. 62.7%) were lower among NAU (p<.05). NAU were more likely to use an OTC medication (38.7% vs. 12.1%) or both a prescription and OTC medication (11.3% vs. 4.3%) to treat stomach-related symptoms (p<.05). NAU were more likely to have had a discussion about their treatment options with their physicians (36.9% vs. 24.5%) rather than have their physician prescribing (60.6% vs. 73.5%) (p<.05). NAU were significantly less likely to have considered switching their medication (10.7% vs. 31.9%). Among those considered switching, cost (62.5%) and insurance coverage (18.8%) were the most common reasons for NAU, and inconvenience factors (“too much of a hassle”; 19.5% and “interfering with my lifestyle”; 12.2%) for warfarin users. CONCLUSIONS: There were some characteristic differences among AF patients. Understanding patients' characteristics may be the first step in helping patients to be adherent to their stroke prevention medications.