Ensuring adherence to therapy with anticoagulation in patients with atrial fibrillation

Estimating Adherence Based on Prescription or Dispensation Information: Impact on Thresholds and Outcomes. A Real-World Study With Atrial Fibrillation Patients Treated With Oral Anticoagulants in Spain

“…Adherence to medical recommendations was high and similar for the most used VKA in Spain (acenocoumarol, PDC80 = 94%) and any of the marketed NOAC (PDC80 between 92 and 94%), contrasting the worst adherence to NOAC (vs. VKA) speculated by some authors based on the lack of close monitoring (INR control) (Rodriguez et al, 2013; Hendriks et al, 2017; Burn and Pirmohamed, 2018). In the same way, adherence to VKA—always taking the medical prescription as reference—does not seem inferior to NOAC adherence, contrary to what is suggested by studies assessing the comparative adherence to VKA and NOAC (McHorney et al, 2017).…”

Adherence, knowledge, and perception about oral anticoagulants in patients with atrial fibrillation at high risk for thromboembolic events after radiofrequency ablation

“…One of the patient‐related factors found to have a negative impact on adherence rates is a deficit in the knowledge and understanding of both the risks and benefits of oral anticoagulants (Clarkesmith, Pattison, Khaing, & Lane, ; Clarkesmith, Pattison, Lip, & Lane, ; Hendriks, Gallagher, & Sanders, ). This lack of knowledge can be largely attributed to a lack of comprehensive information provided to the patient regarding the prescribed treatment regimen (Clarkesmith et al., ; Hendriks et al., ; Lane, Barker, & Lip, ; Lane, Ponsford, Shelley, Sirpal, & Lip, ). Furthermore, patients’ perceptions and beliefs concerning the anticoagulant treatment were found to have an impact on adherence rates in patients with AF (Lane et al., ; Verhoef et al., ).…”

“…Hence, it seems difficult for patients to make a clear and meaningful distinction between the disease risk and the risk/benefit ratio of taking oral anticoagulants (Vander Stichele, Van Dierendonck, De Vooght, Reynvoet, & Lammertyn, ). Furthermore, systematic administration of oral anticoagulants puts a burden on patients’ daily life due to the required monitoring of dose–response relationship (in case of VKA) and lifestyle modifications such as diet, alcohol consumption, daily medication intake, and participation in physical exercise (Hendriks et al., ; Prins et al., ). Such requirements might have an important impact on patients’ adherence rates.…”

Heartbeat: Renin–angiotensin system blockade for prevention of cardiovascular disease

“…Although the reasons for non-persistence could not be determined in this Canadian study, Hendrick, Gallagher and Sanders4 advocate that: ‘A comprehensive integrated approach is needed to incorporate stroke prevention into daily practice, including structured follow-up in those patients on NOAC treatment to evaluate and prevent non-persistence and adverse effects of therapy’ (figure 3). ‘Although patients on NOAC treatment may not require routine blood monitoring to the same degree as those on VKA antagonists, it is clear that this should not be translated to a lack of requirement for monitoring of the individual.’…”