https://orcid.org/0000-0001-7118-8088
Abstract
Purpose
Inadequate medication adherence among patients with non-valvular atrial fibrillation (NVAF) will directly affect the efficacy and safety of anticoagulation therapy, leading to a considerable increase in the risk of ischemic stroke and death. In this study, we aim to investigate medication adherence and identify the influencing factors, including social-demographic, disease-related information and self-efficacy.
Patients and Methods
We recruited 170 patients with NVAF from a tertiary hospital atrial fibrillation outpatient clinics and cardiology ward from June 2020 to September 2020. Patients who had been taking oral anticoagulation medication for at least 3 months were included. And Morisky medication adherence scale (MGL) was used to assess the adherence to anticoagulants, which scores <4 were considered as low adherence.
Results
Fifty (29.4%) NVAF patients had a MGL score<4. Monthly income, types of comorbidities, number of drugs, and self-efficacy were determinants of anticoagulation adherence. Binomial logistic regression showed that patients had been prescribed more durgs (OR: 3.51, p=0.002), had high monthly income (OR: 7.87, p=0.001), without other diseases (OR: 8.00, p=0.005), and with higher self-efficacy (OR: 1.42, p=0.001) showed high adherence.
Conclusion
Number of drugs, types of comorbidities, monthly income, and self-efficacy were associated with the adherence of non-vitamin K antagonist oral anticoagulants (NOACs).
Highlights
Poor oral anticoagulants in patients with non-valvular atrial fibrillation increase the risk of stroke and bleeding.
Adherence was suboptimal in patients with NVAF; the proportion of non-adherent patients is about 30%.
Monthly income, number of drugs, type of comorbidities, and self-efficacy are associated with NOACs adherence.
Abbreviations
NVAF, non-valvular atrial fibrillation; NOACs, non-vitamin K oral anticoagulants; RFCA, radiofrequency catheter ablation.
Acknowledgments
The author would like to thank Wu LQ, Jin Qi, Kang Lei, members of the graduate tutor group, and all patients involved. Ting Song and Xiao Xin are co-first authors for this study.
Author Contributions
All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.
Disclosure
The authors report no conflicts of interest in this work.