Patient Self-Reported Global Satisfaction With Rivaroxaban in Patients With Atrial Fibrillation: A Comparison Between Oral Anticoagulation-Naïve Versus Oral Anticoagulation-Experienced Patients.

BACKGROUND: Long-term oral anticoagulant therapy (OAC) is essential to effective stroke prevention in patients with atrial fibrillation (AF), but adherence to OAC is a concern. Patient self-reported satisfaction with OAC is a major contributor to OAC adherence. We compared the levels of and time trends in patient global satisfaction with rivaroxaban in OAC-naïve and OAC-experienced AF patients. METHODS: An international, prospective, observational study of treatment with generic rivaroxaban included direct oral anticoagulant (DOAC)-eligible AF patients, whether OAC-naïve or previously taking any OAC except rivaroxaban. At enrollment, all participants were prescribed rivaroxaban. Patient self-reported global satisfaction with rivaroxaban was assessed at 3, 6, and 12 months using a modified Treatment Satisfaction Questionnaire for Medication Version 2 (TSQM-II). The lower the TSQM-II value, the higher patient satisfaction level. RESULTS: Of 1020 participants (mean age 68.02 ± 9.65 y, 43.6% female), 630 (61.8%) were OAC-naïve. The mean patient satisfaction level was consistently higher in OAC-experienced versus OAC-naïve patients across all follow-up visits (1.41 ± 0.518 vs. 1.49 ± 0.604, p = 0.034, 1.45 ± 0.552 vs. 1.56 ± 0.585, p = 0.004 and 1.40 ± 0.511 vs. 1.52 ± 0.540, p < 0.001 at 3, 6, and 12 months, respectively). OAC-naïve status was consistently significantly associated with the level of patient satisfaction during follow-up, and significant fluctuations in patient satisfaction levels were observed at 6 months among OAC-naïve but not OAC-experienced patients. CONCLUSION: Our results suggest that OAC-naïve patients need additional support, reassurance and more intense regular clinical follow-up, particularly in the first 6 months after initiation of DOAC therapy.