title: When do patients prefer a direct oral anticoagulant over a vitamin K antagonist?
abstract: BACKGROUND
  The reasons for patients to change their usual vitamin K antagonist (VKA) treatment to a direct oral anticoagulant (DOAC) are unexplored.
  
  
  METHODS
  A random sample of 200 patients treated with VKAs for the indication of atrial fibrillation from the Thrombosis Service in Amsterdam was selected. A survey, using the treatment trade-off technique, was sent to participants. The trade-off included four scenarios: 1 (no need for laboratory controls); 2 (less bleeding); 3 (less interactions); 4 (more effective).
  
  
  RESULTS
  Under scenario 1, 57% of the patients would have made the switch, with a further increase to 65% with scenario 2 (trend value, p = 0.006, 95% CI 1.11-1.85). In addition, in each scenario patients who were less satisfied with their current treatment were more likely to switch to a DOAC compared with satisfied patients. The variables duration of treatment, gender, age and educational level did not affect the preference for a DOAC.
  
  
  CONCLUSIONS
  Patients considered no requirement for regular laboratory control and a lower risk of bleeding the most important arguments to switch to a DOAC.
authors.affiliation: University of Amsterdam, Academic Medical Center, Amsterdam, the Netherlands.
authors.forename: M S
authors.initials: MS
authors.lastname: Boom
authors.forename: E M
authors.initials: EM
authors.lastname: Berghuis
authors.forename: P T
authors.initials: PT
authors.lastname: Nieuwkerk
authors.forename: S
authors.initials: S
authors.lastname: Pinedo
authors.forename: H R
authors.initials: HR
authors.lastname: Büller
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use*; D000991:Antithrombins / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy; D004347:Drug Interactions; D016903:Drug Monitoring; D057915:Drug Substitution; D065427:Factor Xa Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced; D006801:Humans; D008297:Male; D057240:Patient Preference; D014812:Vitamin K / Q000037:antagonists & inhibitors*
chemical_list: D000925:Anticoagulants; D000991:Antithrombins; D065427:Factor Xa Inhibitors; D014812:Vitamin K