1. Self-reported adherence to anticoagulation and its determinants using the Morisky medication adherence scale
- Author
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Joseph R. Shaw, William Petrcich, Marc Carrier, Katrien van der Salm, Petra M. G. Erkens, Grégoire Le Gal, Lana A Castellucci, Thrombosis Program, University of Ottawa [Ottawa], Plymouth Marine Laboratory (PML), Plymouth Marine Laboratory, Department of General Practice (CAPHRI), Maastricht University [Maastricht], Service d'angiologie et d'hémostase (MR), Hôpital Universitaire de Genève, Groupe d'Etude de la Thrombose de Bretagne Occidentale (GETBO), Université de Brest (UBO)-Institut Brestois Santé Agro Matière (IBSAM), Université de Brest (UBO)-Université de Brest (UBO), Clinical Epidemiology Program (PSW), The Ottawa Health Research Institute, and Department of Medecine (OTTAWA - Dpt Med)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Multivariate analysis ,Adolescent ,medicine.drug_class ,Cross-sectional study ,[SDV]Life Sciences [q-bio] ,030204 cardiovascular system & hematology ,Dabigatran ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,Surveys and Questionnaires ,Internal medicine ,medicine ,Humans ,030212 general & internal medicine ,Young adult ,Survey ,Intensive care medicine ,Medication adherence ,Aged ,Aged, 80 and over ,Rivaroxaban ,business.industry ,Anticoagulant ,Anticoagulants ,Atrial fibrillation ,Hematology ,Middle Aged ,medicine.disease ,3. Good health ,Cross-Sectional Studies ,Female ,Apixaban ,Self Report ,business ,Self-report ,[SDV.MHEP]Life Sciences [q-bio]/Human health and pathology ,Venous thromboembolism ,medicine.drug - Abstract
Background Direct oral anticoagulants (DOACs) are used for treatment of venous thromboembolism (VTE) and stroke prevention in atrial fibrillation (AF). Given the shorter half-life and lack of laboratory monitoring compared to vitamin-K antagonists (VKAs), adequate adherence to DOACs is important. Reported anticoagulation adherence is unclear in clinical practice. Objectives To assess self-reported anticoagulation adherence in a tertiary center anticoagulation clinic. Patients/Methods Cross-sectional study of patients on oral anticoagulants (VKAs, rivaroxaban, dabigatran and apixaban). Anticoagulation adherence was assessed using the 4-item Morisky score. Baseline characteristics were evaluated for association with adherence. Results Five hundred patients completed the survey; 74% were on VKAs and 26% on DOACs: rivaroxaban 102 (79%); dabigatran 26 (19%); apixaban 2 (2%). Main indications for anticoagulation were VTE (72%) and AF (18%). Self-reported anticoagulation adherence using the 4-item Morisky scale was 56.2% for patients on VKAs and 57.1% for patients on DOACs. Predictors of anticoagulation adherence were age (OR = 1.02; 95% CI:1.01-1.03), female gender (OR = 1.58; 95% CI:1.10-2.27), use of additional oral medications (OR = 2.78; 95% CI:1.67-4.63), and retired employment status (OR = 2.31; 95% CI:1.51-3.55). In backward selection multivariate analyses age, female gender and use of other oral medications remained significantly associated with anticoagulation adherence. Conclusions Self-reported anticoagulation adherence was similar between VKAs and DOACs. Until laboratory assays are universally available to evaluate DOAC adherence, physicians should emphasize the importance of anticoagulation adherence at each patient encounter. The Morisky scale provides simple assessment of anticoagulation adherence; however it has not yet been validation for this purpose.
- Published
- 2015
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