Patient Self-Reported Global Satisfaction With Rivaroxaban in Patients With Atrial Fibrillation: A Comparison Between Oral Anticoagulation-Naïve Versus Oral Anticoagulation-Experienced Patients.
Markovic B, Mihajlovic M, et al. • Clinical cardiology • 2026
OAC-experienced patients reported consistently higher satisfaction with rivaroxaban than OAC-naïve patients across all follow-up visits, suggesting that OAC-naïve patients need additional support and more intense clinical follow-up, particularly in the first 6 months after DOAC initiation.
Key Findings
Results
OAC-experienced patients reported consistently higher global satisfaction with rivaroxaban than OAC-naïve patients at all three follow-up time points.
At 3 months: OAC-experienced 1.41 ± 0.518 vs. OAC-naïve 1.49 ± 0.604, p = 0.034
At 6 months: OAC-experienced 1.45 ± 0.552 vs. OAC-naïve 1.56 ± 0.585, p = 0.004
At 12 months: OAC-experienced 1.40 ± 0.511 vs. OAC-naïve 1.52 ± 0.540, p < 0.001
Satisfaction was measured using a modified Treatment Satisfaction Questionnaire for Medication Version 2 (TSQM-II), where lower values indicate higher satisfaction
Results
OAC-naïve status was consistently and significantly associated with the level of patient satisfaction throughout the 12-month follow-up period.
OAC-naïve status remained a significant predictor of satisfaction level at all three follow-up visits (3, 6, and 12 months)
Of 1020 total participants, 630 (61.8%) were OAC-naïve and 390 (38.2%) were OAC-experienced
All participants were prescribed rivaroxaban at enrollment regardless of prior OAC status
The study was an international, prospective, observational design
Results
Significant fluctuations in patient satisfaction levels were observed at 6 months among OAC-naïve patients but not among OAC-experienced patients.
OAC-naïve patients showed a dip in satisfaction (higher TSQM-II score) at the 6-month visit compared to 3 and 12 months
OAC-experienced patients did not demonstrate the same pattern of fluctuation at 6 months
This finding suggests that the 6-month period may represent a critical window requiring additional clinical attention for treatment-naïve patients
Methods
The study enrolled 1020 DOAC-eligible atrial fibrillation patients with a mean age of 68.02 ± 9.65 years, of whom 43.6% were female.
Participants were either OAC-naïve or previously taking any OAC except rivaroxaban
All participants were prescribed rivaroxaban (generic formulation) at enrollment
Patient satisfaction was assessed at 3, 6, and 12 months using the modified TSQM-II
The study design was international, prospective, and observational
Conclusions
The authors concluded that OAC-naïve patients require additional support, reassurance, and more intense regular clinical follow-up, particularly in the first 6 months after DOAC initiation.
Patient self-reported satisfaction with OAC was identified as a major contributor to OAC adherence
Long-term OAC therapy is described as essential to effective stroke prevention in AF patients
The recommendations for enhanced follow-up were specifically directed at the first 6 months of therapy based on the observed satisfaction fluctuations in that period
What This Means
This research studied how satisfied atrial fibrillation (AF) patients were with their blood thinner medication (rivaroxaban) depending on whether they had taken blood thinners before. The study followed 1,020 patients over 12 months and measured their satisfaction at 3, 6, and 12 months using a standardized questionnaire. Patients who had previously taken other blood thinners (OAC-experienced) consistently reported higher satisfaction with rivaroxaban compared to patients who were starting blood thinner therapy for the first time (OAC-naïve), and this difference was statistically significant at every time point measured.
A particularly notable finding was that patients who were new to blood thinners showed a notable dip in satisfaction around the 6-month mark that was not seen in experienced patients. This suggests that the first six months of treatment may be an especially challenging period for patients unfamiliar with anticoagulation therapy. Because patient satisfaction is closely linked to whether people continue taking their medications, lower satisfaction among new users is a meaningful clinical concern.
This research suggests that healthcare providers may need to give extra attention, reassurance, and more frequent check-ins to patients who are just beginning blood thinner therapy for AF, particularly during the first six months. Patients experienced with such medications appear to adapt more readily to rivaroxaban and maintain higher satisfaction levels throughout the year. These findings could help clinics design better support programs for newly anticoagulated AF patients to improve long-term medication adherence and, by extension, stroke prevention.
Markovic B, Mihajlovic M, Kocijancic A, Simic J, Marinkovic M, Kovacevic V, et al.. (2026). Patient Self-Reported Global Satisfaction With Rivaroxaban in Patients With Atrial Fibrillation: A Comparison Between Oral Anticoagulation-Naïve Versus Oral Anticoagulation-Experienced Patients.. Clinical cardiology. https://doi.org/10.1002/clc.70461