OBJECTIVES: To identify the potential characteristics of Direct Oral Anticoagulants (DOACs) driving patient preferences for treatment choice in daily clinical practice in Spain.

METHODS: Pilot study to evaluate the most appropriated design for a full-scale research project. Based on literature review, potential differential attributes among DOAC were identified and analysed by a study Steering Committee. A study questionnaire was designed to evaluate the importance of the selected attributes by patients with atrial fibrillation (AF), aged ≥18, treated with a DOAC for ≥6 months following daily clinical practice, capable to fill in the questionnaire and not participating in a clinical trial.

RESULTS: A total of 15 potential differential attributes were identified. Three were discarded due to lack of evidence on DOAC differentiation (prevention of stroke; fix dose administration; treatment monitoring). Two items were excluded as they were considered as patient descriptive (comorbidities, renal insufficiency). The final questionnaire, including ten evaluation items (haemorrhagic complications, interactions (drugs or food), active bleeding, economic considerations, posology/administration way, administration comfort, patient age, cognitive status, caregiver presence, and impact on daily activities) was administered to 39 AF patients with a mean age (standard deviation, SD) of 71.7 (13.0) years, 51.3% were women, treated with a DOAC for 3.1 (2.5) years and using 7.9 (4.6) drugs daily. Considering a 10-point scale, the most important items for patients were: bleeding protocol availability, haemorrhagic risk and treatment cost (8.9; 8.4; 8.0 points, respectively). Regarding administration preferences, main attributes were: easy to swallow, administration conditions, daily administrations, administration moment and crush possibility (7.7, 6.4, 6.3, 5.8 and 5.4 points, respectively).

CONCLUSIONS: Apart from efficacy and safety (priority for AF patients), DOAC differential attributes were based on posology and administration conditions. Specific priorities and preferences should be accurately addressed following this pilot, considering patient profiles and caregiver’s perspective in a full-scale study.