The health-related quality of life of patients on long-term medications is an important aspect of treatment regimens because people are less likely to stick with taking drugs that negatively impact their daily lives. The international Duke Anticoagulation Satisfaction Scale (DASS) is used by medical professionals to monitor this in patients on long-term oral anticoagulant treatment. Scientists at KAIMRC have now translated the DASS into Arabic for the first time and tested its efficacy on a patient cohort in Saudi Arabia. 

Anticoagulants such as warfarin and apixaban help prevent blood clots and strokes in patients with atrial fibrillation and thromboembolic disorders. However, some patients experience significant side effects and are at higher risk of internal bleeding while taking these drugs. Adherence to these drugs can thus be poor, making a survey such as DASS a valuable tool.   

Like any survey, DASS must be tailored to different cultures and translated into different languages while keeping the inherent meaning and implications of each question relevant.  “Since each population group and setting is different, it is important to assess the reliability and validity of a specific tool, especially when it has been translated from another language,” says Khizra Sultana of KAIMRC’s Research Office. “Once we had created the translated Arabic version, we wanted to ensure that it accurately measures patient satisfaction and give consistent results every time it is administered.”

The team therefore asked 439 patients over 18 years old at a large government facility in Saudi Arabia to complete the Arabic DASS. Their analysis of patient responses highlighted three questions that were less relevant for Arabs.

“The questions referred to alcohol intake, which is not relevant to Arab culture, and also to over-the-counter medications, which is not an element of our healthcare system and so would be confusing to patients in Saudi Arabia,” says Sultana. “It is important to note that while we have produced an Arabic language version of the DASS, it is up to individual Arabic-speaking nations to check that the survey fits their specific culture – our version is tailored for Saudi Arabia.”

The remaining questions showed high validity and provided a suitable tool for assessing patient satisfaction with both drugs. Similar to other cultures, the team found that males were more satisfied with the drugs than females, and that older patients tended to be happier with their treatment than younger people. 

“We hope that, as awareness of this new Arabic DASS grows, healthcare professionals across Saudi Arabia will incorporate it into their support programme for patients on long-term anticoagulant treatment,” says Sultana.

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