PREFERENCES AND SELECTION CRITERIA FOR NOVEL ORAL ANTICOAGULANTS AMONG UKRAINIAN PHYSICIANS: RESULTS OF A TARGETED QUESTIONNAIRE SURVEY
DOI:
https://doi.org/10.11603/2312-0967.2026.3.16543Keywords:
novel oral anticoagulants; cardiovascular diseases; physician survey; selection factors; complianceAbstract
Aim of the work – to investigate the factors affecting the selection of novel oral anticoagulants (NOACs) by Ukrainian physicians for cardiovascular diseases, to assess differences in priority and alternative choice criteria, sources of information about NOACs, and to identify the main reasons for patient non-adherence to anticoagulant therapy.
Materials and Methods. The study is based on the results of a targeted survey of specialists conducted at the end of 2025 – beginning of 2026 using purposive (criterion-based) sampling. A specially developed and validated questionnaire served as the research instrument; content validity was assessed by two highly qualified cardiologists holding doctoral degrees. The final version comprised 332 variables. The survey was approved by the Ethics Committee of State non-profit company “Danylo Halytsky Lviv National Medical University” (Protocol No. 12, December 16, 2024). Statistical processing was performed using descriptive statistics (absolute and relative frequencies) with MS Excel.
Results and Discussion. Thirty-eight physicians (cardiologists, surgeons, vascular surgeons) from 8 regions of Ukraine were surveyed. Rivaroxaban was the priority drug across all investigated nosologies: it was selected as the primary drug by 90.0% of respondents treating non-valvular atrial fibrillation (NVAF), 91.4% – pulmonary embolism (PE), 94.4% – deep vein thrombosis (DVT), 88.5% – coronary artery disease without NVAF, and 100.0% – intermittent claudication. Selection criteria differed depending on the clinical context: for acute thromboembolic conditions (PE, DVT), physicians more frequently cited evidence base and safety profile than for NVAF. Leading information sources were pharmaceutical company representative visits (97.4%), international clinical guidelines (86.8%), and scientific conferences (84.2%); overall information accessibility was rated highly (mean score 4.63/5.0). The majority (60.5%) preferred original NOACs. The primary reason for treatment discontinuation was high drug cost (92.1%). In 2026, three NOACs were included in the national reimbursement programme, although financial barriers remain significant.
Conclusions. Rivaroxaban is the priority drug in real-world clinical practice, consistent with Ukrainian pharmaceutical market trends. Key physician decision-making criteria involve evidence base, therapeutic efficacy, and long-term safety. High drug cost remains the primary barrier to patient adherence, while once-daily dosing is an effective adherence-promoting factor.
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