Evidence map›Paper›PMID 31601729›Full record

Observational studyHeart (British Cardiac Society)2020

Adherence and persistence to direct oral anticoagulants in atrial fibrillation: a population-based study.

Amitava Banerjee, Valerio Benedetto, Philip Gichuru, Jane Burnell, Sotiris Antoniou, Richard J Schilling, William David Strain, Ronan Ryan, Caroline Watkins, Tom Marshall and 1 more

Abstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Heart (British Cardiac Society), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 57 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
57citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

57 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. The effect of reminder mobile application use on medication adherence after total thyroidectomy: a randomized controlled trial.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Amitava BanerjeeInstitute of Health Informatics, University College London, London, UK ami.banerjee@ucl.ac.uk.ORCID 0000-0001-8741-3411
Valerio BenedettoFaculty of Health and Wellbeing, University of Central Lancashire, Preston, United Kingdom.
Philip GichuruEdge Hill University, Ormskirk, UK.
Jane BurnellSchool of Health Sciences, University of Central Lancashire, Preston, UK.
Sotiris AntoniouBarts Health NHS Trust, London, UK.
Richard J SchillingDepartment of Cardiology, Barts and The London NIHR Cardiovascular Biomedical Research Unit and The William Harvey Research Institute, London, UK.
William David StrainDiabetes and Vascular Medicine Research, University of Exeter, Exeter, UK.
Ronan RyanPrimary Care Clinical Sciences, University of Birmingham, Birmingham, UK.
Caroline WatkinsFaculty of Health and Wellbeing, University of Central Lancashire, Preston, United Kingdom.
Tom MarshallPrimary Care Clinical Sciences, University of Birmingham, Birmingham, UK.
Chris J SuttonDivision of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK.

Funding

Department of Health
6 · The paper itself

Abstract

backgroundDespite simpler regimens than vitamin K antagonists (VKAs) for stroke prevention in atrial fibrillation (AF), adherence (taking drugs as prescribed) and persistence (continuation of drugs) to direct oral anticoagulants are suboptimal, yet understudied in electronic health records (EHRs).

objectiveWe investigated (1) time trends at individual and system levels, and (2) the risk factors for and associations between adherence and persistence.

methodsIn UK primary care EHR (The Health Information Network 2011-2016), we investigated adherence and persistence at 1 year for oral anticoagulants (OACs) in adults with incident AF. Baseline characteristics were analysed by OAC and adherence/persistence status. Risk factors for non-adherence and non-persistence were assessed using Cox and logistic regression. Patterns of adherence and persistence were analysed.

resultsAmong 36 652 individuals with incident AF, cardiovascular comorbidities (median CHA

conclusionsAdherence and persistence to OACs are low at 1 year with heterogeneity across drugs and over time at individual and system levels. Better understanding of contributory factors will inform interventions to improve adherence and persistence across OACs in individuals and populations.

Indexed as

Medication AdherenceAdministration, OralAgedAged, 80 and overAntithrombinsAtrial FibrillationDrug UtilizationElectronic Health RecordsFactor Xa InhibitorsFemaleHumansIncidenceMaleMiddle AgedPractice Patterns, Physicians'Preventive Health ServicesAntithrombinsFactor Xa Inhibitorsadherenceanticoagulantatrial fibrillationpersistencestroke

Identifiers

PMID31601729
PMCPMC6993026

What OpenQuestion holds

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Registered trials

None linked

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.