Determinants of health-related quality of life: A cross-sectional investigation in physician-managed anticoagulated patients using Vitamin K antagonists: Health and Quality of Life Outcomes

A. Magon, C. Arrigoni, M. Moia, M. Mancini, F. Dellafiore, D.F. Manara, R. Caruso

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Literature has paid little attention in describing the specific contribution of each modifiable and non-modifiable characteristics on health-related quality of life (HRQoL) in physician-managed anticoagulated patients using Vitamin K antagonists (VKAs). To describe how patients' treatment-specific knowledge, health literacy, treatment beliefs, clinical, and socio-demographic characteristics influence HRQoL in Italian physician-managed anticoagulated patients using VKAs. Methods: Cross-sectional multicentre study with a consecutive sampling strategy, enrolling 164 long-term anticoagulated patients. Clinical and socio-demographic characteristics were collected from electronic medical records. Valid and reliable questionnaires were used to collect patients' treatment-specific knowledge, health literacy, beliefs about VKAs, physical and health perceptions. Results: Obtaining and understanding health information (i.e., communicative health literacy) positively predicts both adequate mental (ORadjusted = 10.9; 95%CI = 1.99-19.10) and physical (ORadjusted = 11.54; 95%CI = 1.99-34.45) health perceptions. Conversely, the ability to perform proper health decision making (i.e., critical health literacy) was associated with lower rates of adequate mental health perception (ORadjusted = 0.13; 95%CI = 0.03-0.63). Further, age negatively predicted physical health perception (ORadjusted = 0.87; 95%CI = 0.81-0.93). Conclusions: Health literacy plays an interesting role in predicting HRQoL. The relationship between critical health literacy and mental health perception could be influenced by some psychological variables, such as distress and frustration, which could be present in patients with higher levels of critical health literacy, as they could be more inclined for self-monitoring. For this reason, future research are needed to identify the most suitable patients' profile for each OAC-management model, by longitudinally describing the predictive performance of each modifiable and non-modifiable determinant of HRQoL. © 2020 The Author(s).
Original languageEnglish
Article number73
JournalHealth Qual. Life Outcomes
Volume18
Issue number1
DOIs
Publication statusPublished - 2020

Keywords

  • Health literacy
  • Oral anticoagulants
  • Predictors
  • Quality of life
  • antivitamin K
  • blood clotting factor 10a inhibitor
  • vitamin K group
  • aged
  • anticoagulation
  • Article
  • attitude to health
  • clinical decision making
  • clinical feature
  • cross-sectional study
  • distress syndrome
  • doctor patient relationship
  • electronic medical record
  • female
  • frustration
  • health belief
  • health literacy
  • human
  • Italy
  • major clinical study
  • male
  • medical information
  • mental health
  • observational study
  • prediction
  • quality of life
  • questionnaire
  • self monitoring
  • social determinants of health
  • adult
  • clinical trial
  • longitudinal study
  • middle aged
  • multicenter study
  • patient education
  • Adult
  • Cross-Sectional Studies
  • Factor Xa Inhibitors
  • Female
  • Humans
  • Longitudinal Studies
  • Male
  • Middle Aged
  • Patient Medication Knowledge
  • Quality of Life
  • Surveys and Questionnaires
  • Vitamin K

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