Login
Search
Search
0 Dates
2024
2023
2022
2021
2020
2019
2018
0 Events
CPC 2018
CPC 2019
Curso de Atualização em Medicina Cardiovascular 2019
Reunião Anual Conjunta dos Grupos de Estudo de Cirurgia Cardíaca, Doenças Valvulares e Ecocardiografia da SPC
CPC 2020
CPC 2021
CPC 2022
CPC 2023
CPC 2024
0 Topics
A. Basics
B. Imaging
C. Arrhythmias and Device Therapy
D. Heart Failure
E. Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care
F. Valvular, Myocardial, Pericardial, Pulmonary, Congenital Heart Disease
G. Aortic Disease, Peripheral Vascular Disease, Stroke
H. Interventional Cardiology and Cardiovascular Surgery
I. Hypertension
J. Preventive Cardiology
K. Cardiovascular Disease In Special Populations
L. Cardiovascular Pharmacology
M. Cardiovascular Nursing
N. E-Cardiology / Digital Health, Public Health, Health Economics, Research Methodology
O. Basic Science
P. Other
0 Themes
01. History of Cardiology
02. Clinical Skills
03. Imaging
04. Arrhythmias, General
05. Atrial Fibrillation
06. Supraventricular Tachycardia (non-AF)
07. Syncope and Bradycardia
08. Ventricular Arrhythmias and Sudden Cardiac Death (SCD)
09. Device Therapy
10. Chronic Heart Failure
11. Acute Heart Failure
12. Coronary Artery Disease (Chronic)
13. Acute Coronary Syndromes
14. Acute Cardiac Care
15. Valvular Heart Disease
16. Infective Endocarditis
17. Myocardial Disease
18. Pericardial Disease
19. Tumors of the Heart
20. Congenital Heart Disease and Pediatric Cardiology
21. Pulmonary Circulation, Pulmonary Embolism, Right Heart Failure
22. Aortic Disease
23. Peripheral Vascular and Cerebrovascular Disease
24. Stroke
25. Interventional Cardiology
26. Cardiovascular Surgery
27. Hypertension
28. Risk Factors and Prevention
29. Rehabilitation and Sports Cardiology
30. Cardiovascular Disease in Special Populations
31. Pharmacology and Pharmacotherapy
32. Cardiovascular Nursing
33. e-Cardiology / Digital Health
34. Public Health and Health Economics
35. Research Methodology
36. Basic Science
37. Miscellanea
0 Resources
Abstract
Slides
Vídeo
Report
CLEAR FILTERS
Medication adherence to direct anticoagulants in patients with non-valvular AF – a real world analysis
Session:
Posters 5 - Écran 3 - Arritmologia
Speaker:
Catarina Brízido
Congress:
CPC 2019
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.5 Atrial Fibrillation - Stroke Prevention
Session Type:
Posters
FP Number:
---
Authors:
Catarina Brízido; António Miguel Ferreira; Pedro M. Lopes; Christopher Strong; Gustavo Da Rocha Rodrigues; Anai Durazzo; Daniel Nascimento Matos; Gustavo Sá Mendes; Francisco Fernandes Gama; Sara Guerreiro; Sérgio Madeira; Pedro Adragão; Miguel Mendes
Abstract
<p><u>Introduction</u>:</p> <p>Direct oral anticoagulants (DOACs) changed the landscape of atrial fibrillation (AF) treatment, but also brought new challenges in terms of accessibility and compliance. The purpose of this study was to assess medication adherence to DOACs, and its determinants in a population of AF patients.</p> <p><u>Methods</u>:</p> <p>In this single-center retrospective study, all the patients with non-valvular AF treated with a DOAC were identified from the outpatient lists of 15 different cardiologists in a tertiary center. Patients were included if a DOAC was first prescribed from April 1<sup>st</sup> 2016 (onset of mandatory electronic prescription) to August 2018. Electronic prescription platform was used to count the number of pharmacy refills from the day of first prescription to August 31<sup>st</sup> 2018. Medication refill adherence (MRA) was calculated by dividing the number of pharmacy refills by the number of days under therapy (accounting for drug-specific posology and the number of pills per package). Non-compliance was defined as MRA < 90%.</p> <p><u>Results </u></p> <p>A total of 264 patients (120 men, mean age 74±12 years) met the inclusion criteria. The median CHA<sub>2</sub>DS<sub>2</sub>VAS<sub>C</sub> score was 3 (IQR 2-5), while the median HAS-BLED was 1 (IQR 1-2). Rivaroxaban, Apixaban, Dabigatran and Edoxaban were prescribed in 45%, 41%, 24% and 13% of patients, respectively. Throughout the study period 51 patients (19%) used more than one DOAC.</p> <p>Patients were under DOAC therapy for a median period of 439 days (IQR 269-638), during which the mean MRA was 83±20% (median MRA 90%, IQR 75-100%). Only 84 patients (32%) were fully adherent (figure). Overall, 134 of the patients (51%) were classified as non-compliant. In univariate and multivariate analyses, therapy duration (adjusted OR 1.06 per month, 95%CI 1.03-1.08, p<0.001), <em>bid</em> posology (adjusted OR 1.73, 95%CI 1.08-2.75, p=0.022), and higher patient copayments (adjusted OR 2.13, 95%CI 1.28-3.45, p=0.003) were independent predictors of non-compliance.</p> <p><u>Conclusion</u></p> <p>In our population of patients with non-valvular AF treated with DOACs, the mean medication refill adherence was 83%, suggesting that patients may be unprotected or underprotected almost 20% of the time. Therapy duration, <em>bid</em> posology and higher patient copayments were independent predictors of non-compliance. Greater efforts should be taken to improve patient accessibility and adherence to DOAC therapy.</p>
Our mission: To reduce the burden of cardiovascular disease
Visit our site