ArticlePharmacoepidemiology and drug safety2008
Risk factors for nonadherence to warfarin: results from the IN-RANGE study.
Article in Pharmacoepidemiology and drug safety, 2008. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 45 papers.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
45 citing papers in PubMed.
- Reduced anticoagulation variability in patients on warfarin monitored with Fiix-prothrombin time associates with reduced thromboembolism: The Fiix-trial.Journal of thrombosis and thrombolysis · 2017Trial
- Cognitive factors associated with adherence to oral antiestrogen therapy: results from the cognition in the study of tamoxifen and raloxifene (Co-STAR) study.Cancer prevention research (Philadelphia, Pa.) · 2014Trial
- Randomized trial of lottery-based incentives to improve warfarin adherence.American heart journal · 2012Trial
- Effectiveness and Safety in Patients with Non-Valvular Atrial Fibrillation Who Switched from Warfarin to Direct Oral Anticoagulants in Medicare Population.Advances in therapy · 2025Article
- How drug onset rate and duration of action affect drug forgiveness.Journal of pharmacokinetics and pharmacodynamics · 2024Article
- Lower-adherence direct oral anticoagulant use is associated with increased risk of thromboembolic events than warfarin.Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing · 2024Article
- A call for action to include psychosocial management into holistic, integrated care for patients with atrial fibrillation.Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology · 2024Article
- Thromboembolic Antiphospholipid Syndrome (APS): Efficacy and Safety of Different Anticoagulants-Results of the APSantiCO Registry.Journal of clinical medicine · 2022Article
- Optimizing adherence and persistence to non-vitamin K antagonist oral anticoagulant therapy in atrial fibrillation.European heart journal supplements : journal of the European Society of Cardiology · 2022Article
- Challenges of Anticoagulation Management Service and Need of Establishing Pharmacist-Led Anticoagulation Clinic in Tertiary Care Teaching Hospital, Ethiopia: A Qualitative Study.Journal of multidisciplinary healthcare · 2022Article
- Article
- Impact of adherence to warfarin therapy during 12 weeks of pharmaceutical care in patients with poor time in the therapeutic range.Journal of thrombosis and thrombolysis · 2021Article
- Integrated Care in Atrial Fibrillation: A Road Map to the Future.Circulation. Cardiovascular quality and outcomes · 2021Review
- Barriers and facilitators to optimal oral anticoagulant management: a scoping review.Journal of thrombosis and thrombolysis · 2020Article
- Antithrombotic Preventive Medication Prescription Redemption and Socioeconomic Status in Hungary in 2016: A Cross-Sectional Study.International journal of environmental research and public health · 2020Article
- Determining INR Awareness of the Patients who Use Warfarin and Rates of Achieving the Target Dosage.Sisli Etfal Hastanesi tip bulteni · 2020Article
- Geriatric Elements and Oral Anticoagulant Prescribing in Older Atrial Fibrillation Patients: SAGE-AF.Journal of the American Geriatrics Society · 2020Article
- Instruments for the assessment of patient adherence to oral anticoagulation with warfarin protocol for a systematic review.Medicine · 2019Article
- Risk factors for medication non-adherence among atrial fibrillation patients.BMC cardiovascular disorders · 2019Observational
- Associations between illness beliefs, medication beliefs, anticoagulation-related quality of life, and INR control: Insights from the Switching Study.Research and practice in thrombosis and haemostasis · 2018Article
Corrections and comments
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Authors and funding
14 authors.
Funding
Abstract
backgroundWarfarin is widely used to prevent stroke and venous thromboembolism despite its narrow therapeutic window. Warfarin nonadherence is a substantial problem, but risk factors have not been well elucidated.
methodsA prospective cohort study of adults initiating warfarin at two anticoagulation clinics (University and VA-affiliated) was performed to determine factors affecting nonadherence to warfarin. Nonadherence, defined by failure to record a correct pill bottle opening each day, was measured daily via electronic medication event monitoring systems (MEMS) caps. A multivariable explanatory model using logistic regression for longitudinal data was used to identify risk factors for nonadherence.
resultsOne hundred eleven subjects were followed for a median of 137 days. Warfarin nonadherence was common (4787 of 22,425 or 21% of patient-days observed). Factors independently associated with higher odds of nonadherence included education beyond high school (odds ratio (OR) 1.8 (95%CI 1.2-2.7)), lower Short Form (SF)-36 mental component score (OR 1.4 (1.1-1.6) for each 10 point decrease); and impaired cognition (< or =19 points) on the Cognitive Capacity Screening Examination (CCSE) (OR 2.9 (1.7-4.8)). Compared to currently employed subjects, unemployed (OR 0.6 (0.3-1.2)) and retired (OR 0.5 (0.3-0.8)) subjects had somewhat improved adherence; disabled subjects over age 55 had worse adherence (OR 1.8 (1.1-3.1)) than younger disabled subjects (OR 0.8 (0.4-1.5)).
conclusionsPoor adherence to warfarin is common and risk factors are related to education level, employment status, mental health functioning, and cognitive impairment. Within the carefully controlled anticoagulation clinic setting, such patient-specific factors may be the basis of future interventions to improve nonadherence.
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