Evidence map›Paper›PMID 25694538›Full record

ReviewEuropace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology2015

Non-vitamin K antagonist oral anticoagulants: considerations on once- vs. twice-daily regimens and their potential impact on medication adherence.

Bernard Vrijens, Hein Heidbuchel

Registry-linked trialOpen access · bronzeAbstract readReview
PubMed Publisher
In one paragraph

Review in 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, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03555448 (Once a Day Immunosuppression Regimen), which is not on this map. Cited by 63 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 2 pooled it
16.4field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

NCT03555448 phase4terminatednot on this mapstarted 2018, after this paper: background citation

Once a Day Immunosuppression Regimen: Outcomes and Compliance

TypeinterventionalSponsorWashington University School of MedicineRan2018 to 2023Enrolled51ConditionsKidney Transplant, ComplicationsArmsOnce daily immunosuppression regimen, Twice daily immunosuppression regimen
3 · Its place in the literature

Who cites it

63 citing papers in PubMed, 2 syntheses or guidelines pooled it, 170 citations in OpenAlex.

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  17. Adherence to oral anticoagulation measured by electronic monitoring in a Belgian atrial fibrillation population.Clinical research in cardiology : official journal of the German Cardiac Society · 2023
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3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

2 authors at 1 institution in 1 country.

Bernard VrijensMWV Healthcare, Rue des Cyclistes Frontière 24, 4600 Visé, Belgium Department of Biostatistics and Medical Informatics, CHU Sart Tilman, Liège.
Hein HeidbuchelHasselt University and Heart Center, Jessa Hospital, Jessa Ziekenhuis, Stadsomvaart 11, 3500 Hasselt, Belgium heinheid@gmail.com.
Jessa Hospital · BE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Suboptimal medication adherence is a widespread problem in ambulatory care of chronic diseases, with deviations in either direction from the prescribed dosing regimen. For the non-vitamin K antagonist oral anticoagulants (NOACs), such deviations occur and can lead to bleeding or clotting, as suboptimal adherence involves temporary periods of either overdosing or underdosing. In this expert review, we discuss: (a) the proper definition of adherence in terms of its three elements: initiation, implementation, and discontinuation; (b) how adherence is reliably and accurately measured and (c) successfully enhanced, to achieve and maintain safe and effective levels of NOAC-based anticoagulation. We also discuss the comparative effects of prescribing the same total daily dose, given either once-daily or as half-strength twice-daily doses. Because NOACs have plasma half-lives of ∼12 h, the twice-daily dosing regimen is less prone than the once-daily dosing regimen to hazardously high peaks or hazardously low troughs in anticoagulant concentrations and associated actions. As in other fields of oral drug treatment, the continuity of drug action is greater with twice-daily than with once-daily dosing, despite the fact that a few more doses are skipped with twice-daily than with once-daily dosing. This paradox is explained by the disproportionately greater impact on drug action of skipping a once-daily than a twice-daily dose. Integration of these principles into real-world medication management is the next step in the improvement of oral anticoagulation.

Indexed as

Drug Administration ScheduleMedication AdherenceAdministration, OralAnticoagulantsDose-Response Relationship, DrugHumansThromboembolismVitamin KAnticoagulantsVitamin KAnticoagulationAtrial fibrillationComplianceDosing regimensMedication adherenceMonitoringNew oral anticoagulantsStroke

Identifiers

PMID25694538
OpenAlexW2164643105

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.