title: Psychological effects of treatment with new oral anticoagulants in elderly patients with atrial fibrillation: a preliminary report.
abstract: OBJECTIVE
  Atrial fibrillation (AF) is the most common arrhythmia in elderly people, yet oral anticoagulation is underused in the aged. We tried to determine whether new oral anticoagulants (NOA) have greater psychological tolerability than warfarin.
  
  
  METHODS
  Age-, gender-matched groups of AF patients receiving NOA (N = 15) or warfarin (N = 15) were assessed with the Anti-Clot Treatment Scale (ACTS) and the Perceived Stress Scale (PSS).
  
  
  RESULTS
  Patients were old (81 ± 9 years). NOA group showed greater psychological satisfaction, with lower therapy-related burden (ACTS burdens: 16.3 ± 4.5 vs. 32.9 ± 10.2, p < 0.001) and higher awareness of benefits (ACTS benefits: 13.0 ± 1.3 vs. 10.8 ± 1.9, p = 0.001). Even stress was lower (PSS: 13.1 ± 4.0 vs. 17.1 ± 4.2, p = 0.013). The multivariate analysis confirmed these findings, showing that higher levels of anxiety and depression could justify more stress in warfarin patients.
  
  
  CONCLUSIONS
  The results of this preliminary study show that NOA have an improved psychological impact compared with warfarin in elderly patients.
authors.affiliation: Intensive Care Unit and Geriatric Arrhythmology Unit, Division of Geriatric Cardiology and Medicine, and Research Unit of Medicine of Aging, Department of Experimental and Clinical Medicine, University of Florence and AOU Careggi, Viale Pieraccini, 6, 50139, Florence, Italy, fumadue@tin.it.
authors.forename: Stefano
authors.initials: S
authors.lastname: Fumagalli
authors.forename: Francesca
authors.initials: F
authors.lastname: Cardini
authors.forename: Anna T
authors.initials: AT
authors.lastname: Roberts
authors.forename: Serena
authors.initials: S
authors.lastname: Boni
authors.forename: Debbie
authors.initials: D
authors.lastname: Gabbai
authors.forename: Silvia
authors.initials: S
authors.lastname: Calvani
authors.forename: Marta
authors.initials: M
authors.lastname: Casalone Rinaldi
authors.forename: Stefania
authors.initials: S
authors.lastname: Manetti
authors.forename: Francesca
authors.initials: F
authors.lastname: Tarantini
authors.forename: Niccolò
authors.initials: N
authors.lastname: Marchionni
mesh_terms: D000284:Administration, Oral; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D017060:Patient Satisfaction; D013315:Stress, Psychological / Q000209:etiology; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin