Health-related quality of life correlates with time in therapeutic range in children under anticoagulants with INR self-monitoring

Abstract

In paediatrics, managing oral anticoagulant therapy with vitamin K antagonists (VKA) remains challenging. This study aimed to assess the correlation between time in therapeutic range (TTR) and quality of life (QoL) in children participating in a non-selective INR self-monitoring VKA-educational program. Children aged from 2 to 18 years under VKA therapy were eligible for this prospective multicentre study. Clinical and demographic data were collected. Health-related QoL was assessed using the PedsQL 4.0 questionnaire. Correlations between QoL scores and TTR were measured. A total of 121 children were included in the study (mean age 9.6 ± 4.9 years old). Cardiac conditions represented the predominant indication for VKA. The mean TTR was 0.78 ± 0.15, overall, and 0.76 ± 0.24 over the 3-month period before QoL assessment. The mean total QoL score was 76.2 ± 18 in self-reports, 71.4 ± 22 in mother-reports, and 73.5 ± 19 in father-reports. The TTR correlated with the total QoL scores, in self-reports ( r = 0.22, P = 0.04), mother-reports ( r = 0.23, P = 0.02), and father-reports ( r = 0.28, P = 0.02). The TTR predominantly correlated with school functioning in self-reports ( r = 0.38, P = 0.002) and mother-reports ( r = 0.40, P < 0.01), and with physical functioning in father-reports ( r = 0.28, P = 0.02). TTR correlated with QoL in children participating in a non-selective INR self-monitoring VKA-educational program. Regular assessment of QoL in patient education programs participates in understanding the concerns and needs of patients.