Presentation Details
| Longitudinal Changes in Health-related Quality of Life (HRQL) during Anticoagulation Therapy in Cancer-associated Venous Thromboembolism Treatment Taylor A Hopper1, Eva Ordonez Mazariegos2, Andrea Jimena Morales Arteaga3, Cristhiam M Rojas Hernandez2. 1The University of Texas Health Science Center at Houston, Houston, TX, USA.2The University of Texas MD Anderson Cancer Center, Houston, TX, USA.3Tecnologico de Monterrey, School of Medicine and Health Sciences, Monterrey, Mexico |
Abstract
Introduction: There are multiple options for treatment of cancer associated-venous thromboembolism (CAT) in patients with active malignancy. This provides the opportunity for patients and providers to tailor treatment to improve patient’s health-related quality of life (HRQL) as well as adherence. Previous studies have documented the impact on HRQL by CAT. It is unknown how HRQL in CAT impacts anticoagulation adherence. Therefore, our objective was to explore how changes in anticoagulant selection overtime influences HRQL and adherence. Method: A longitudinal study of adult cancer patients with confirmed acute VTE without other comorbidities requiring anticoagulation were included in the population. They were followed 30 days, 3 months, and 6 months after enrollment to identify current anticoagulant therapy, complete HRQL questionnaires using a seven-point Likert scale, and a self-reported adherence tool. Adherence rates were calculated at 3 and 6 months using 95% confidence intervals. We compared categorical variables with Pearson Chi Squared tests and continuous variables with non-parametric methods, according to the distribution and number of groups of anticoagulants. Additionally, we plotted time to change of anticoagulant with the Kaplan-Meier method. During this 6-month follow-up period, there were no observed deaths. Results: Of the patients followed, 28 were included in the analysis as they had completed all surveys for baseline, 3 months, and 6 months. It was found that 11 patients changed anticoagulants, all of whom started on low molecular weight heparin (LMWH) except for one individual; this is a statistically significant change (P = .016) as the patients that started on direct oral anticoagulation (DOAC) changed less frequently. Furthermore, patients that did change treatment endorsed greater emotional distress and more negative symptoms than their counterparts (P = .036, P = .047). Conclusion: This study suggests that tailoring treatment to patients' emotional distress can improve HRQL without any impact on adherence. Therefore, it is critical for providers to identify a patient's stressors and negative symptoms to appropriately tailor their treatment. Furthermore, according to our analysis, change of anticoagulant occurs more frequently in the beginning of CAT treatment; therefore, proper counseling should be given to patients to ensure clear understanding of clinical course and likely treatment adjustments.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.
No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author.