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DOI: 10.1055/s-0037-1613605
Quality of life and the duration of treatment with vitamin K antagonists in patients with deep venous thrombosis
Publikationsverlauf
Received
06. Dezember 2002
Accepted after revision
07. März 2003
Publikationsdatum:
07. Dezember 2017 (online)
Summary
In clinical practice, decisions on the duration of treatment with vitamin K antagonists are usually based on the presence of persistent risk factors, the risk of bleeding and centre policy. Little is known about the influence of patients’ experienced quality of life. The objectives of this study were: 1) to explore the course of quality of life in patients with venous thrombosis treated for 3 months versus patients treated for 6 months with vitamin K antagonists; 2) to investigate the factors that were associated with the duration of treatment with vitamin K antagonists. The study sample comprised patients participating in a multi-centre clinical trial. Quality of life was assessed at study entry, after 10-14 days,3 and 6 months in 360 patients. Overall, no dif-ferences in quality of life were found between the 2 patient groups. An interaction effect between group and time was found for physical functioning. Regression analyses indicated that the presence of one or more permanent risk factors, duration of hospitalisation, mobility prior to deep-vein thrombosis and study centre were associated with the duration of treatment with vitamin K antagonists. Interestingly, quality of life was not associated with treatment duration. Since study centre was the most important factor associated with treatment duration, local policy appears to have a great influence on decisions regarding the duration of treatment with vitamin K antagonists.
Part of this manuscript has been included in a poster presentation at the International Society for Quality of Life Research in Amsterdam, The Netherlands, November 8, 2001.
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References
- 1 Hirsh J, Dalen JE, Anderson DR. et al. Oral anticoagulants: Mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest 2001; 119: 8s-21s.
- 2 Fairweather RB, Ansell J, van den Besselaar AMHP. et al. College of American Pathologists Conference XXXI on laboratory monitoring of anticoagulant therapy: laboratory monitoring of oral anticoagulant therapy. Arch Pathol Lab Med 1998; 122: 768-81.
- 3 Cromheecke ME, Levi M, Colly LP. et al. Oral anticoagulation self-management and management by a specialist anticoagulation clinic: a randomised cross-over comparison. Lancet 2000; 356: 97-102.
- 4 Kulinna W, Ney D, Wenzel T. et al. The effect of self-monitoring the INR on quality of anticoagulation and quality of life. Semin Thromb Hemos 1999; 25: 123-6.
- 5 Sawicki PT. for the working group for the study of patient self-management of oral anticoagulation. A structured teaching and self-management program for patients receiving oral anticoagulation: a randomized controlled trial. JAMA 1999; 281: 145-50.
- 6 Barcellona D, Contu P, Sorano GG. et al. The management of oral anticoagulant therapy: the patient’s point of view. Thromb Haemost 2000; 83: 49-53.
- 7 Lancaster TR, Singer DE, Sheehan MA. et al. for the Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators. The impact of long-term warfarin therapy on quality of life: evidence from a randomized trial. Arch Intern Med 1991; 151: 1944-9.
- 8 Koopman MMW, Prandoni P, Piovella F. et al. for the TASMAN Study group. Treatment of venous thrombosis with intravenous unfractionated heparin administered in the hospital as compared with subcutaneous low-molecular-weight heparin administered at home. N Engl J Med 1996; 334: 682-7.
- 9 Stewart AL, Ware JE. (editors). Measuring functioning and well-being: the medical outcomes study approach. Durham, N.C.; Duke University press: 1992
- 10 Kempen GIJM. The MOS-short-form general health survey: single versus multiple measures of health related quality of life: Some nuances. Psychological Rep 1992; 70: 608-10.
- 11 De Haes JCJM, van Knippenberg FCE, Neijt JP. Measuring psychological and physical distress in cancer patients: Structure and applications of the Rotterdam Symptom Checklist. Brit J Cancer 1990; 60: 1034-8.
- 12 Nunnally JC. Psychometric theory, 2nd edition. New York: MacGraw-Hill; 1978
- 13 Hürny C, Bernhard J, Gelber RD. et al. for the International Breast Cancer Study group. Quality of life measures for patients receiving adjuvant therapy for breast cancer: An international trial. Eur J Cancer 1992; 28: 118-24.
- 14 Levine MN, Hirsh J, Gent M. et al. Optimal duration of oral anticoagulant therapy: a ran-domized trial comparing four weeks with three months of warfarin in patients with proximal deep vein thrombosis. Thromb Haemost 1995; 74: 606-11.
- 15 Schulman S, Rhedin AS, Lindmarker P. et al. and the Duration of Anticoagulation Trial Study Group. A comparison of six weeks with six months of oral anticoagulation therapy after a first episode of venous thromboembolism. N Eng J Med 1995; 332: 1661-5.
- 16 Kearon CM, Gent M, Hirsch J. et al. A comparison of three months of anticoagulation with extended anticoagulation for a first episode of idiopathic venous thromboembolism. N Eng J Med 1999; 340: 901-7.
- 17 Agnelli G, Prandoni P, Santamaria MG. et al. and the Warfarin Optimal Duration Italian Trial investigators. Three months versus one year of oral anticoagulant therapy for idiopathic deep vein thrombosis. N Engl J Med 2001; 345: 165-9.
- 18 Van den Belt AGM, Hutten BA, Prins MH. et al. Duration of oral anticoagulant treatment in patients with venous thromboembolism and a deficiency of antithrombin, protein C or protein S A decision analysis. Thromb Haemost 2000; 84: 758-63.