Health-Related Quality of Life and Its Associated Factors Among Patients on Long-Term Warfarin Therapy for Atrial Fibrillation at Selected Public Hospitals, Addis Ababa Ethiopia, A Cross-Sectional Study
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Date
2025
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Addis Ababa Universtity
Abstract
Atrial fibrillation (AF) affects approximately 37.5 million people globally, with its
prevalence increasing by 33% over the past two decades. This growing burden contributes to
serious complications such as heart failure, stroke, and increased healthcare utilization. Warfarin
remains a commonly used long-term anticoagulant for stroke prevention in AF patients, despite
its management challenges. The chronic nature of AF and the demands of warfarin therapy can
negatively affect patients’ health-related quality of life (HRQoL).
Objective: To assess health-related quality of life and its associated factors among patients on
long-term warfarin therapy for atrial fibrillation at selected public hospitals in Addis Ababa,
Ethiopia, in 2025
Methods: An institution-based descriptive cross-sectional study was conducted from February
19 to March 19, 2025, among 401 randomly selected adult patients on warfarin therapy for at
least 6 months. Data were collected using the validated Short Form-36 (SF-36) questionnaire
through face-to-face interviews and medical chart was reviewed using prepared checklist. Data
were collected by two trained nurses and one nurse was assigned as supervisor. Descriptive
statistics summarized participant characteristics. Multiple linear regression analysis was
performed using SPSS version 27 to identify factors associated with HRQoL. A p-value < 0.05
was considered statistically significant.
Results: Factors significantly associated with lower HRQoL scores (PCS and MCS) included
older age, male gender, lower educational attainment, valvular AF, higher CHA2DS2-VASc
scores, and taking more than two medications per day. For every 10-year increase in age, PCS
and MCS scores decreased by 0.203 and 0.343 points, respectively. Male patients and those with
valvular AF had significantly lower HRQoL scores compared to their counterparts.
Conclusion and Recommendations: This study found that age, sex, education level, AF type,
stroke risk scores, and polypharmacy significantly impact HRQoL in warfarin-treated AF
patients. Interventions focusing on modifiable factors, integrated care approaches, and patient centered strategies are recommended to enhance quality of life in this population.
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Keywords
Atrial Fibrillation, Health-Related Quality of Life, Warfarin, Ethiopia, SF-36