ArticleClinical research in cardiology : official journal of the German Cardiac Society2014
Adherence to warfarin treatment among patients with atrial fibrillation.
Article in Clinical research in cardiology : official journal of the German Cardiac Society, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers.
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The trial behind it
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Who cites it
22 citing papers in PubMed.
- A Web-Based Integrated Management Program for Improving Medication Adherence and Quality of Life, and Reducing Readmission in Patients With Atrial Fibrillation: Randomized Controlled Trial.Journal of medical Internet research · 2021Trial
- Rationale and design of the ODIn-AF Trial: randomized evaluation of the prevention of silent cerebral thromboembolism by oral anticoagulation with dabigatran after pulmonary vein isolation for atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Trial
- Rationale and design of the RE-LATED AF--AFNET 7 trial: REsolution of Left atrial-Appendage Thrombus--Effects of Dabigatran in patients with Atrial Fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Trial
- Neuropsychological impact of cerebral microemboli in ablation of atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2015Trial
- Article
- General practice-related variation in oral anticoagulant treatment of atrial fibrillation: a nationwide cohort study.BJGP open · 2025Article
- 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
- Ischemic stroke as the initial manifestation of atrial fibrillation; is it higher than expected?Journal of cardiovascular and thoracic research · 2021Article
- Association of prestroke medicine use and health outcomes after ischaemic stroke in Sweden: a registry-based cohort study.BMJ open · 2020Article
- Association Between Warfarin Control Metrics and Atrial Fibrillation Outcomes in the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation.JAMA cardiology · 2019Article
- Less dementia and stroke in low-risk patients with atrial fibrillation taking oral anticoagulation.European heart journal · 2019Article
- Warfarin Use and Mortality, Stroke, and Bleeding Outcomes in a Cohort of Elderly Patients with non-Valvular Atrial Fibrillation.Journal of atrial fibrillation · 2019Article
- A prospective, multi-center cohort study: investigating the ability of warfarin-treated patients to predict their INR.Clinical research in cardiology : official journal of the German Cardiac Society · 2019Article
- Comparative safety and effectiveness of direct oral anticoagulants in patients with atrial fibrillation in clinical practice in Scotland.British journal of clinical pharmacology · 2019Article
- Prognosis in patients with atrial fibrillation and a presumed "temporary cause" in a community-based cohort study.Clinical research in cardiology : official journal of the German Cardiac Society · 2017Article
- Age is associated with time in therapeutic range for warfarin therapy in patients with atrial fibrillation.Oncotarget · 2016Article
- General practitioners' adherence to chronic heart failure guidelines regarding medication: the GP-HF study.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Article
- Comparison of treatment persistence with different oral anticoagulants in patients with atrial fibrillation.European journal of clinical pharmacology · 2016Article
- Physical activity, symptoms, medication and subjective health among veteran endurance athletes with atrial fibrillation.Clinical research in cardiology : official journal of the German Cardiac Society · 2016Article
- Predictors of warfarin non-adherence in younger adults after valve replacement surgery in the South Pacific.Heart Asia · 2016Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTreatment with warfarin greatly reduces the risk of stroke related to atrial fibrillation, but will not be effective unless patients adhere to treatment. Lack of fixed dosing makes it difficult to objectively estimate adherence to treatment from prescription data.
objectiveTo evaluate two methods that assess adherence to warfarin from prescription data.
designRetrospective study of Swedish health care registers. PATIENTS AND
methodsAge- and sex-specific dose requirements were determined from approx. 1 million blood tests and dosing instructions. By applying these dosages to 163,785 warfarin-treated patients with atrial fibrillation, we calculated the quantity of warfarin that was needed to keep these patients on effective treatment during a mean follow-up of 3.9 years and compared that with the dispensed quantities. The ratio of available drug/time at risk constitutes a measure of adherence on group level. In addition, time intervals between refills were used to assess discontinuation.
resultsBoth methods showed that 45% of the patients did not have enough warfarin to last 80% of the time at risk. Between 16 and 21% of the patients discontinued within the first year, followed by 8-9% annually during the following years. Patients with high bleeding risk and patients with low embolic risk showed lower endurance.
conclusionsAdherence to treatment with warfarin can be estimated on group level from prescription data and may be useful for comparison of adherence with warfarin and new oral anticoagulants. When applied to a large warfarin-treated cohort with atrial fibrillation, we found that adherence is low and that measures aiming for improvements are needed .
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Registered trials
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