OBJECTIVES: To assess the main value drivers, preferences and satisfaction of patients treated with Direct Oral Anticoagulants (DOAC) in Spain.

METHODS: Observational, multicentric (25 hospitals), cross-sectional study, based on patients and caregivers’ interview, in Spain. Patients with atrial fibrillation (AF), aged ≥18, DOAC users (≥6 months) were included (and/or caregivers, when possible). Main data (DOAC attributes importance, preferences and satisfaction) was collected through an ad-hoc survey, based on 10-points Likert scales. Three study groups were considered according to DOAC posology preferences: (A) once daily, with water; (B) once daily, with food; (C) twice daily.

RESULTS: The study included 332 patients and 55 caregivers. Mean (SD) patients’ age was 73.7 (10.7) years [58.7 (13.9) for caregivers]; 51.5% were women [69.1% of caregivers]. Most patients (80.7%) showed comorbidities and were treated with 6.6 (3.3) daily drugs. Mean time using DOAC was 23.8 (18.1) months. No statistically significant differences among study groups were shown. Haemorrhagic risk was the main priority for both, patients and caregivers, followed by DOAC posology conditions and interactions. Once daily administration was preferred by 274 patients (82.5%) [60.8% (A); 21.7% (B); 17.5% (C)], and caregivers (85.5%) [58.2% (A); 27.3% (B); 14.5% (C)]. Despite that, only 42.8% patients were treated with a once-daily ACOD, being reduced to 23.8% in case of patients treated with a single dose, with water (the most preferred option). Patients and caregivers satisfaction was high (9.0 and 9.1 points, respectively), specially for once-daily DOACs, with water.

CONCLUSIONS: DOAC selection must be based on clinical criteria (efficacy and safety). However, when different options could be considered, patient and/or caregiver preferences should become a key selection driver for decision-making (currently, 82.5% of patients would prefer single-dose DOACs versus 42.8% using single-dose DOACs). Specific guidelines should be developed for balance clinical criteria and preferences in DOAC choice.