ArticleJournal of the American Heart Association2019
Trajectories of Oral Anticoagulation Adherence Among Medicare Beneficiaries Newly Diagnosed With Atrial Fibrillation.
Article in Journal of the American Heart Association, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 1 of them a synthesis that pooled it.
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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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
50 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Medication Adherence Trajectories: A Systematic Literature Review.Journal of managed care & specialty pharmacy · 2020Pooled it
- Effect of Shared Decision-Making for Stroke Prevention on Treatment Adherence and Safety Outcomes in Patients With Atrial Fibrillation: A Randomized Clinical Trial.Journal of the American Heart Association · 2022Trial
- Assessment of Shared Decision-making for Stroke Prevention in Patients With Atrial Fibrillation: A Randomized Clinical Trial.JAMA internal medicine · 2020Trial
- Article
- Patterns of Adherence and Persistence to Triple and Quadruple Guideline-Directed Medical Therapy Among US Patients With Heart Failure With Reduced Ejection Fraction.Journal of the American Heart Association · 2026Observational
- The importance and challenge of comparing stroke care, utilization and outcomes in Medicare Advantage and Fee-for-Service Medicare: a narrative review and vision for the future.Journal of comparative effectiveness research · 2026Review
- Medication adherence trajectories and association with risk factors and clinical outcomes in type 2 diabetes treatment.PloS one · 2026Article
- Patient Knowledge and Adherence to Oral Anticoagulation Therapy: Findings from an Observational Study in Italian Tertiary Care Hospitals.Patient preference and adherence · 2026Article
- Chronic Disease Management to Enhance Medication Adherence Trajectories in Long-Term Survivors of Stroke: A Population-Based Cohort Study.Pharmacoepidemiology and drug safety · 2025Observational
- Investigating the Time-Varying Nature of Medication Adherence Predictors: An Experimental Approach Using Andersen's Behavioral Model of Health Services Use.Pharmacy (Basel, Switzerland) · 2025Article
- Real-world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in Spain.Frontiers in pharmacology · 2025Article
- Prediction of long-term adherence to direct oral anti-coagulants in patients with atrial fibrillation using first-order Markov models.Frontiers in pharmacology · 2025Article
- Delay and Pay? Healthcare Costs Associated with Late Oral Anti-coagulant Prescribing in People with Atrial Fibrillation.PharmacoEconomics · 2024Article
- Association Between Oral Anticoagulant Adherence and Serious Clinical Outcomes in Patients With Atrial Fibrillation: A Long-Term Retrospective Cohort Study.Journal of the American Heart Association · 2024Observational
- COVID-19 Diagnosis, Oral Anticoagulation, and Stroke Risk in Patients with Atrial Fibrillation.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2024Article
- Trajectories of Sacubitril/Valsartan Adherence Among Medicare Beneficiaries With Heart Failure.JACC. Advances · 2024Article
- COVID-19 pandemic and trends in clinical outcomes and medication use for patients with established atrial fibrillation: A nationwide analysis of claims data.American heart journal plus : cardiology research and practice · 2024Article
- Predictors of adherence to direct oral anticoagulants after cardiovascular or bleeding events in Medicare Advantage Plan enrollees with atrial fibrillation.Journal of managed care & specialty pharmacy · 2024Article
- Evaluating the effect of inequalities in oral anti-coagulant prescribing on outcomes in people with atrial fibrillation.European heart journal open · 2024Article
- Opioid therapy trajectories of patients with chronic non-cancer pain over 1 year of follow-up after initiation of short-acting opioid formulations.Pain medicine (Malden, Mass.) · 2024Article
Corrections and comments
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Authors and funding
6 authors.
Funding
Abstract
Background Only 50% of atrial fibrillation ( AF ) patients recommended for oral anticoagulation ( OAC ) use these medications, and less than half of them adhere to OAC . In a cohort of Medicare beneficiaries newly diagnosed with AF , we identified groups of patients with similar trajectories of OAC use and adherence, and evaluated patient characteristics affecting group membership. Methods and Results We selected continuously enrolled Medicare Part D beneficiaries with first AF diagnosis in 2014 to 2015 (n=34 898). We calculated the proportion of days covered with OAC over the first 12 months after diagnosis and identified OAC adherence trajectories using group-based trajectory models. We constructed multinomial logistic regression models to evaluate how demographics, system-level factors, and clinical characteristics were associated with group membership. We identified 4 trajectories of OAC adherence: patients who never used OAC (43.8%), late OAC initiators (7.6%), early OAC discontinuers (8.9%), and continuously adherent patients (40.1%). Predictors such as sex, black race, residence in the South, or HAS - BLED score were associated with not only OAC use, but also the timing of initiation and the likelihood of discontinuation. For example, HAS - BLED score ≥4 was associated with a higher likelihood of not using OAC (odds ratio 1.35; 95% CI , 1.14-1.62), of late initiation (1.55; 95% CI , 1.11-2.05), and of early discontinuation (odds ratio 1.35; 95% CI , 1.01-1.84). Conclusions We identified 4 distinct trajectories of OAC adherence after first AF diagnosis, with <45% of newly diagnosed AF patients belonging to the trajectory group characterized by continuous OAC adherence. Trajectories were associated not only with demographic and clinical characteristics but also with regional factors.
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