Warfarin therapy adherence and health-related quality of life among patients using warfarin in Saudi Arabia

Background: Treatment satisfaction and medication adherence to oral anticoagulant therapy are important measures that often decrease morbidity and mortality. Though warfarin is a frequently prescribed oral anticoagulant, warfarin therapy adherence (WTA) and its impact on overall Health-Related Quality of Life (HRQoL) has not been studied in Saudi Arabia. Objectives: To assess the association between WTA and HRQoL among patients on warfarin in Saudi Arabia. Methods: A prospective, cross-sectional, descriptive study was conducted on 387 patients on warfarin therapy attending an outpatient anticoagulation clinic in Alkharj, Saudi Arabia. WTA was assessed using medication adherence measuring scale (MAMS) whereas HRQoL was measured using World Health Organization QOL-BREF (WHOQOL-BREF). Descriptive and inferential statistics were used to examine patients' demographic characteristics and to determine the association among different variables. Spearman's correlation coefficient was used to determine the association between various study variables. Results: Of the total 387 participants, there were more females than males (n=257, 66.4%, and n=130, 33.6% respectively). The mean adherence score for the study population was 5.86±1.21. Mean HRQoL score for physical health domain, psychological domain, social relationships domain, and environment domain were 62.11±15.53, 68.20±16.11, 64.46±26.19 and 63.43±17.60 respectively. The correlation coefficients for all the four domains of the WHOQOL-BREF vs total mean score of warfarin therapy adherence were 0.124, 0.051, 0.063 and 0.083 respectively indicating a weak positive association between warfarin therapy adherence and physical health domain (P < 0.005). Study results indicate a positive association between WTA and the physical health domain of the WHOQOL-BREF among patients on warfarin. Conclusion: Better warfarin therapy adherence can improve the physical health of patients on warfarin.