Warfarin Adherence Among Patients with Atrial Fibrillation in Rural Area of Dongyang, China: A Questionnaire-Based Study

Abstract

Introduction Adherence to warfarin is associated with improved outcome in patients with atrial fibrillation (AF), but the adherence status of patients in rural areas of China is not known. Methods A questionnaire-based study evaluating warfarin adherence of rural residents with AF was carried out in Dongyang, China. Potentially eligible patients were screened and contacted by telephone, and their demographic characteristics were collected. Illness perception was assessed using the Brief Illness Perception Questionnaire (BIPQ), and warfarin adherence was assessed using a Chinese-version adherence scale. Univariate and multivariate analyses were conducted to identify factors associated with unsatisfactory adherence. Results A total of 201 patients (male, n =99; mean age, 70.3±8.12 years) were included, among whom 95 (47.3%) patients showed good adherence and 63 (31.3%) poor adherence. Number of co-dispensed drugs (multivariate analysis: odds ratio [OR]=3.64, 95% confidence interval [CI] 1.35–9.81, p =0.011) and BIPQ score (OR=1.25, 95% CI 1.17–1.33, p <0.001) were identified as factors associated with good adherence. Conclusion Medical adherence to warfarin needs to improve in rural patients with AF. Efforts that can reduce the number of co-dispensed drugs and increase illness perception may improve warfarin adherence. This study may benefit future management of warfarin administration to rural patients with AF.

Inr tracking with face-to-face and phone app

“…A lack of adherence to warfarin medication may make it difficult to keep the INR value within the desired range, which could lead to issues like excessive or subtherapeutic bleeding risks or excessive anticoagulation, which raises the risk of stroke and thromboembolic events. Chen et al [13] found that 47.3% of those who received warfarin treatment had good compliance. Tülek et al [14] reported that 79.8% of the patients had high compliance Similarly, in our study, adherence to drug treatment was good in both groups, which we think is due to the telephone application reminding patients to use the drug.…”