Reply to “On the quality-of-life questionnaires in atrial fibrillation”

Barrios, V.; Escobar, C.

doi:10.1016/j.rceng.2019.10.004

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Velasco Montes, S. González Díez" "autores" => array:2 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Velasco Montes" ] 1 => array:2 [ "nombre" => "S." 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Barrios, C. Escobar" "autores" => array:2 [ 0 => array:4 [ "nombre" => "V." "apellidos" => "Barrios" "email" => array:1 [ 0 => "vivenciobarrios@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:2 [ "etiqueta" => "*" "identificador" => "cor0005" ] ] ] 1 => array:3 [ "nombre" => "C." "apellidos" => "Escobar" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital Universitario Ramón y Cajal, Universidad de Alcalá, Madrid, Spain" "etiqueta" => "a" "identificador" => "aff0005" ] 1 => array:3 [ "entidad" => "Servicio de Cardiología, Hospital Universitario La Paz, Madrid, Spain" "etiqueta" => "b" "identificador" => "aff0010" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Réplica a «Sobre los cuestionarios de calidad de vida en fibrilación auricular»" ] ] "textoCompleto" => "We would first like to thank the authors for their interest in our study, which included more than 1000 patients with nonvalvular atrial fibrillation and at high thromboembolic risk. The patients started treatment either with vitamin K antagonists or with dabigatran in the month prior to inclusion in the study. After 6 months of treatment, the quality of life did not change substantially for the group taking the vitamin K antagonists; however, the quality of life did improve significantly for the patient group treated with dabigatran.<a class="elsevierStyleCrossRef" href="#bib0005">1</a>However, the authors were surprised by the use of the validated AF-QoL18 questionnaire to reach this conclusion, because the initial validation of the questionnaire was conducted at 3 months of follow-up. We would like to clarify certain aspects on this issue. Our study has certain clinical relevance, because atrial fibrillation and anticoagulation with vitamin K antagonists are associated with a worsening of quality of life.<a class="elsevierStyleCrossRefs" href="#bib0010">2–4</a> It is therefore important to understand whether the new anticoagulant treatments can improve this aspect that is so relevant to patients’ lives. Moreover, we do not fully understand the reference chosen by the authors for this criticism, given that the citation corresponds to a different questionnaire (AFEQT).<a class="elsevierStyleCrossRef" href="#bib0025">5</a> Although it is true that the AF-QoL18 questionnaire was initially validated to assess health-related quality of life at 3 months of follow-up, the researchers themselves indicated that given the results, it is likely that this questionnaire is able to detect changes in quality of life in longer follow-ups.<a class="elsevierStyleCrossRefs" href="#bib0030">6,7</a> In fact, several recently published studies employed the AF-QoL18 questionnaire for follow-ups of up to 1year, with consistent results.<a class="elsevierStyleCrossRefs" href="#bib0040">8,9</a>Given that patients with atrial fibrillation need to undergo long-term anticoagulant therapy, we considered that conducting a quality-of-life study that was limited to the first 3 months of treatment would be insufficient for truly perceiving the quality of life associated with anticoagulant therapy. We therefore considered a follow-up period of 6 months. Our study observed a progressive improvement in quality of life with dabigatran. Although the improvement began in the first month of follow-up, it became more intense in month 6. It is quite possible that with a shorter follow-up period (3 months), this progression in improving the quality of life might not have been detected with sufficient intensity." "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2019-10-11" "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "Please cite this article as: Barrios V, Escobar C. Réplica a «Sobre los cuestionarios de calidad de vida en fibrilación auricular». Rev Clin Esp. 2020;220:146–147." ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:9 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Calidad de vida, adherencia y satisfacción en pacientes con fibrilación auricular tratados con dabigatrán o antagonistas de la vitamina K" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Barrios" 1 => "C. Escobar" 2 => "G. Barón Esquivias" 3 => "J.J. Gómez Doblas" 4 => "E. Recalde del Vigo" 5 => "L. Segura Martinez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rce.2018.12.006" "Revista" => array:6 [ "tituloSerie" => "Rev Clin Esp" "fecha" => "2019" "volumen" => "219" "paginaInicial" => "285" "paginaFinal" => "292" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/30894251" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Health-related quality of life and associated factors in patients with atrial fibrillation: an integrative literature review" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "Y.J. Son" 1 => "K.H. Baek" 2 => "S.J. Lee" 3 => "E.J. 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Vol. 220. Issue 2.

Pages 146-147 (March 2020)

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