P128 | ANTI-CLOT TREATMENT SCALE ASSESSMENT IN A SINGLE CENTER ANALYSIS OF 202 PATIENTS IN ANTI-VITAMIN K TREATMENT

Introduction Direct oral anticoagulants (DOACs) are nowadays extensively used; however, anti-vitamin K (AVKs) remains effective and reserved for patients (pts) with specific indications. Pts assessed with the Anti-Clot Treatment Scale (ACTS) on DOACs therapy are more “highly satisfied” than those receiving AVKs. The study aims are: - to understand the satisfaction of pts at our center taking AVKs assessed with the ACTS - to identify factors associated with better satisfaction. Methods We enrolled 202 consecutive pts evaluated for INR. The pts were on AVKs therapy for a median of 10.87 years (range 0.14 – 29.73). The patients filled the validated ACTS after EC study approval. The clinic information was collected from pts or from electronic medical records (Table 1). Based on ACTS, we compared patients in the first quartile (≤59) with those in the fourth quartile (≥71). Student's t test was applied to compare the averages of ACTS between groups and X2 to assess the correlation of risk factors. Univariate and multivariate analyses were performed to assess the predictors of “high satisfaction.” Results As shown in table 1, pts ≥60 years old (yo), men, ECOG ≥1, venous thrombosis history have higher ACTS. Patients who have started AVK for less than 1/2 year are less satisfied. Univariate analyses showed that male sex, ≥60 yo, ECOG ≥1, no thrombosis history, start AVK >1 and >2 years represented predictors of high satisfaction. In multivariate analyses, male sex and ECOG ≥1 were confirmed (OR 2.9, 2.8: 95% CI 1.14 - 7.46, 1.1 - 7.18 and p 0.025, 0.03, respectively). Analyzing pts on anticoagulant for atrial fibrillation/deep vein thrombosis, 65/110 (59.1%) would have no contraindication to switch to DOAC; 13/21 pts (61.9%) among the least satisfied quartile. These pts have been receiving AVKs for a median of 11.92 years (4.29 - 25.47). Discussion According to our data, it is reasonable to assume that frail pts see, in the INR check, an act of care that makes them feel safe and secure. At variance with other studies, men in our cohort appeared to be more satisfied than women. Taking AVK for a long time would seem to increase confidence with the drug. Interestingly, a venous thrombosis history worsens the perception of anticoagulant treatment. The young and fit pts, instead, appeared to feel the burden of AVK therapy and continuous blood sampling. For them, if possible, alternative therapy with DOACs should be considered.