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Adherence, persistence, and switching patterns of dabigatran etexilate
The American Journal of Managed Care
|January 24, 2014
Summary
Nearly 40% of patients stopped dabigatran within six months. Most patients discontinuing dabigatran were not switched to warfarin, indicating potential gaps in anticoagulation management.
Area of Science:
- Pharmacology
- Clinical Pharmacy
- Real-World Evidence
Background:
- Dabigatran is a direct oral anticoagulant used for stroke prevention.
- Understanding real-world adherence and persistence is crucial for effective anticoagulation therapy.
Purpose of the Study:
- To investigate medication adherence, treatment persistence, and switching patterns in patients initiating dabigatran.
- To compare these outcomes between warfarin-naïve and warfarin-experienced patients.
Main Methods:
- A descriptive analysis was performed using pharmacy claims databases.
- Patients initiating dabigatran were identified and followed for 180 days post-initiation.
- Medication adherence was measured by proportion of days covered (PDC), and persistence was assessed. Switching to warfarin was also determined.
Main Results:
- Overall, 39.9% of 17,691 patients were nonpersistent to dabigatran within 180 days.
- Proportion of days covered (PDC) was similar between warfarin-naïve (0.674) and warfarin-experienced (0.712) cohorts.
- Among patients who discontinued dabigatran, 16.1% of warfarin-naïve and 41.1% of warfarin-experienced patients initiated warfarin.
Conclusions:
- A significant proportion of patients discontinue dabigatran therapy within six months.
- The majority of patients discontinuing dabigatran were not subsequently treated with warfarin, suggesting potential gaps in anticoagulation management.
- These findings underscore the need for improved monitoring and management strategies for patients on dabigatran in routine clinical practice.
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