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Updated: Jan 20, 2026
Robotic Ablation of Atrial Fibrillation
Published on: May 29, 2015
Anticoagulation adherence and its associated factors in patients with atrial fibrillation: a cross-sectional study
Pei-Ti Chen1, Tsae-Jyy Wang2, Ming-Hsiung Hsieh3
1Nursing, Cardinal Tien Junior College of Healthcare and Management, Taipei, Taiwan.
Insights
Patients with atrial fibrillation (AF) showed similar adherence to warfarin and novel oral anticoagulants (NOACs). Higher self-efficacy and fewer perceived barriers were linked to better anticoagulant adherence.
Area of Science:
- Cardiology
- Pharmacology
- Patient Adherence Research
Background:
- Atrial fibrillation (AF) management requires effective anticoagulation therapy.
- Understanding factors influencing patient adherence to anticoagulants is crucial for treatment success.
- Both warfarin and novel oral anticoagulants (NOACs) are used, with adherence being a key concern.
Purpose of the Study:
- To investigate anticoagulant adherence in patients with atrial fibrillation (AF).
- To identify factors associated with adherence, including demographics, clinical variables, AF severity, knowledge, satisfaction, perceived barriers, perceived benefits, symptom severity, and self-efficacy.
- To compare adherence between warfarin and NOACs.
Main Methods:
- A cross-sectional study involving 151 patients with AF from cardiology clinics in Taiwan.
- Data collected via questionnaires assessing AF severity, warfarin knowledge, service satisfaction, perceived benefits and barriers, and self-efficacy.
- Statistical analysis using multiple linear regression to identify predictors of adherence.
Main Results:
- No statistically significant difference in adherence was found between warfarin and NOACs.
- Perceived barriers (β=0.18, p=0.017) and self-efficacy (β=-0.48, p<0.001) were significant predictors of anticoagulation adherence.
- Perceived barriers and self-efficacy explained 34.0% of the variance in adherence.
Conclusions:
- Adherence to NOACs was not superior to warfarin in this patient cohort.
- Patients reporting fewer perceived barriers and higher self-efficacy demonstrated better adherence to anticoagulation therapy.
- Interventions aimed at reducing perceived barriers and enhancing self-efficacy may improve anticoagulant adherence in AF patients.
Objective:
To investigate anticoagulant adherence and its associated factors, including demographics, clinical variables, atrial fibrillation (AF) severity, knowledge, satisfaction with services, perceived barriers, perceived benefits, symptom severity and self-efficacy in patients with AF.
Design:
This is a cross-sectional study.
Participants And Setting:
A convenient sample of patients with AF were recruited from cardiology clinics of two teaching hospitals in Taiwan.
Measures:
Data were collected using the study questionnaires, including the AF-related symptom subscale of the AF Severity Scale, the Knowledge of Warfarin Anticoagulation Treatment Scale, the Satisfaction Scale about Service and Warfarin Treatment, the perceived benefits subscale of the Beliefs about Anticoagulation Survey, the Concerns about Anticoagulation Therapy Scale, The Self-efficacy for Appropriate Medication Use Scale and the short-form Adherence to Refills and Medications Scale.
Results:
A total of 151 patients with AF participated in the study; 53 treated with warfarin and 98 treated with novel oral anticoagulants (NOACs). The difference in adherence to warfarin (mean=8.6; SD=1.6) and NOACs (mean=8.9; SD=2.0) was statistically insignificant. Multiple linear regression analysis showed that perceived barriers (β=0.18, p=0.017) and self-efficacy (β=-0.48, p<0.001) were significant predictors of anticoagulation adherence. For every 1-unit increase in the perceived barriers, there will be a 0.18-unit increase in the adherence to anticoagulation therapy. For every 1-unit increase in the self-efficacy, there will be a 0.48-unit decrease in the adherence to anticoagulation therapy. Perceived barriers and self-efficacy collectively explained 34.0% of the variance in adherence to anticoagulation therapy (F(2,149)=38.11, p<0.001).
Conclusion:
We found no better adherence to NOACs compared with warfarin. Patients with greater self-efficacy and perceived fewer barriers showed better adherence to anticoagulation therapy.
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