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Long-Term Adherence to Direct Oral Anticoagulants in Patients with Atrial Fibrillation: A Comparative Cross-Sectional

Anouk J W Gulpen1,2,3, Dionne C W Braeken1, Simon Schalla2,4

  • 1Thrombosis Expert Center Maastricht and Laboratory for Clinical Thrombosis and Hemostasis, Maastricht, The Netherlands.

Acta Haematologica
|March 20, 2022
PubMed

Insights

Structured follow-up significantly improved direct oral anticoagulant (DOAC) adherence in nonvalvular atrial fibrillation (AF) patients compared to standard care. Once-daily DOAC regimens also showed higher adherence and fewer minor bleeding events.

Area of Science:

  • Cardiology
  • Pharmacology
  • Patient Care Management

Background:

  • Long-term direct oral anticoagulants (DOACs) are crucial for preventing stroke in nonvalvular atrial fibrillation (AF) patients.
  • Therapeutic adherence significantly influences clinical outcomes in AF management.
  • Structured follow-up protocols may enhance long-term DOAC adherence.

Purpose of the Study:

  • To evaluate the impact of structured follow-up on long-term DOAC adherence.
  • To compare adherence rates between patients receiving structured follow-up and standard care.
  • To assess the relationship between DOAC dosing frequency and adherence.

Main Methods:

  • Cross-sectional study comparing structured follow-up patients with standard care patients.
  • All participants had used DOACs for over two years.
  • Adherence measured using the Morisky Medication Adherence Scale-8 (MMAS-8) via an online portal.

Main Results:

  • Structured follow-up resulted in higher mean MMAS-8 scores (7.55 vs. 7.25, p=0.045) and high adherence rates (64.1% vs. 50%, p=0.05).
  • Once-daily DOAC regimens showed significantly higher adherence (MMAS-8 score 7.74 vs. 7.00, p<0.001).
  • Minor bleeding rates were lower in the structured follow-up group (10.6% vs. 21.4%, p=0.038).

Conclusions:

  • Structured follow-up enhances long-term DOAC adherence in AF patients compared to standard care.
  • Once-daily DOAC regimens are associated with improved adherence.
  • Structured follow-up may reduce minor bleeding events, warranting further investigation.
Abstract

Keywords:
AdherenceDirect oral anticoagulantsThrombosis

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