ArticleBMC cardiovascular disorders2019
Real-world adherence for direct oral anticoagulants in a newly diagnosed atrial fibrillation cohort: does the dosing interval matter?
Article in BMC cardiovascular disorders, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
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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.
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
21 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Adherence and persistence with direct oral anticoagulants by dose regimen: A systematic review.British journal of clinical pharmacology · 2025Pooled it
- Switching between direct oral anticoagulants: a systematic review and meta-analysis.Journal of thrombosis and thrombolysis · 2021Pooled it
- Pooled it
- Construction of a Multidisciplinary Follow-Up Indicator System Based on the ABC Pathway for Patients with Atrial Fibrillation After Ablation: A Delphi Study.Journal of multidisciplinary healthcare · 2026Article
- Coronary sinus thrombosis: insights from a comprehensive literature review.Thrombosis journal · 2025Review
- Handling delayed or missed direct oral anticoagulant doses: model-informed individual remedial dosing.Blood advances · 2024Article
- Prescription and switching patterns of direct oral anticoagulants in patients with atrial fibrillation.Research and practice in thrombosis and haemostasis · 2024Article
- Role of a National Health Service Electronic Prescriptions Database in the Detection of Prescribing and Dispensing Issues and Adherence Evaluation of Direct Oral Anticoagulants.Healthcare (Basel, Switzerland) · 2024Article
- Real-World Data on the Incidence of Stroke, Myocardial Infarction, and Mortality Among Nonvalvular Atrial Fibrillation Patients in Türkiye: New Oral Anticoagulants-TURKey Study.Anatolian journal of cardiology · 2024Article
- Anticoagulation Adherence: Bridging the Gap between Acute Stroke Treatment and Long-Term Secondary Prevention.Cerebrovascular diseases extra · 2024Article
- Prevalence and Predictors of Nonadherence to Direct Oral Anticoagulant Treatment in Patients with Atrial Fibrillation.TH open : companion journal to thrombosis and haemostasis · 2023Article
- Article
- Once versus twice daily direct oral anticoagulants in patients with recent stroke and atrial fibrillation.European stroke journal · 2022Article
- High Prevalence of Atrial Fibrillation in a Lithuanian Stroke Patient Cohort.Medicina (Kaunas, Lithuania) · 2022Observational
- Adherence and persistence to oral anticoagulants in patients with atrial fibrillation: A Belgian nationwide cohort study.Frontiers in cardiovascular medicine · 2022Article
- Long-Term Medication Adherence Trajectories to Direct Oral Anticoagulants and Clinical Outcomes in Patients With Atrial Fibrillation.Journal of the American Heart Association · 2021Article
- Factors associated with primary nonadherence to newly initiated direct oral anticoagulants in patients with nonvalvular atrial fibrillation.Journal of managed care & specialty pharmacy · 2021Observational
- Electronic monitoring of adherence to once-daily and twice-daily direct oral anticoagulants in patients with atrial fibrillation: Baseline data from the SMAAP-AF trial.Journal of arrhythmia · 2021Article
- Medication Use Quality and Safety in Older Adults: 2019 Update.Journal of the American Geriatrics Society · 2021Review
- Updating the Cost Effectiveness of Oral Anticoagulants for Patients with Atrial Fibrillation Based on Varying Stroke and Bleed Risk Profiles.PharmacoEconomics · 2020Article
Corrections and comments
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Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDifferences in adherence may represent drug properties (e.g. dosing interval) or patient experiences while on treatment. Adherence to direct oral anticoagulants (DOACs) in nonvalvular atrial fibrillation (NVAF) is important to maintain effectiveness over the course of treatment.
methodsThis was a retrospective cohort study using 2009-2015 Truven Health MarketScan Databases. New initiators of dabigatran, rivaroxaban, and apixaban with NVAF were identified. Twelve months of continuous enrollment before treatment was required to assess demographics and medical history. Proportion of days cover (PDC) was used to measure adherence at 3, 6, 9 and 12-month. Gaps in therapy and treatment switches were also evaluated. Logistic regression was used to compare high adherence (PDC ≥0.80).
resultsA total of 14,864 dabigatran, 16,005 rivaroxaban, and 8078 apixaban users were identified. Apixaban users had the highest adherence overall, with mean PDC at 3, 6, 9, and 12-months of 0.83, 0.76, 0.72, and 0.69, while dabigatran had the lowest adherence of 0.78, 0.67, 0.61, and 0.57. Adherence to DOACs increased with increased stroke risk scores. Adherence was also higher when first days supplied was > 30 days compared to 30 days and when filled via mail order pharmacies. Switching was highest among dabigatran users. Apixaban users were the most likely to have high adherence versus dabigatran (OR = 1.73, 95% CI = 1.60-1.88) and versus rivaroxaban (OR = 1.24, 95% CI = 1.14-1.34) at 12-months.
conclusionsApixaban users had the highest overall adherence despite twice-daily dosing versus once-daily dosing for rivaroxaban. These findings can be useful for formulary decision-making and when assessing treatment options.
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