SynthesisBMJ open2020
Adherence to oral anticoagulants among patients with atrial fibrillation: a systematic review and meta-analysis of observational studies.
Synthesis in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 75 papers, 5 of them syntheses that pooled 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.
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
75 citing papers in PubMed, 5 syntheses or guidelines pooled it.
- Clinical characteristics and outcomes of ischemic stroke despite appropriate oral anticoagulation for atrial fibrillation: A systematic review and meta-analysis of real-world studies.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2025Pooled it
- Residual Stroke Risk Among Patients With Atrial Fibrillation Prescribed Oral Anticoagulants: A Patient-Level Meta-Analysis From COMBINE AF.Journal of the American Heart Association · 2024Pooled it
- Impacts of medication non-adherence to major modifiable stroke-related diseases on stroke prevention and mortality: a meta-analysis.Journal of neurology · 2023Pooled it
- Oral anticoagulants: a systematic overview of reviews on efficacy and safety, genotyping, self-monitoring, and stakeholder experiences.Systematic reviews · 2022Pooled it
- Guideline Adherence As An Indicator of the Extent of Antithrombotic Overuse and Underuse: A Systematic Review.Global heart · 2022Pooled it
- Digital recruitment and prevalence of screen-detected atrial fibrillation in nationwide patch-based ECG screening: the NORSCREEN randomized clinical trial.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 · 2026Trial
- A mobile relational agent to enhance atrial fibrillation self-care: Primary and secondary outcomes of a randomized controlled trial.American heart journal · 2025Trial
- Not all cost conversations are the same: An exploration of potential value in cost conversations during Atrial fibrillation treatment decision making.Patient education and counseling · 2024Trial
- Patient adherence and comprehension of take-home anticoagulant regimens prescribed at the emergency department: preliminary findings from a randomized controlled trial and implications for patient safety.Internal and emergency medicine · 2022Trial
- Discontinuation of oral anticoagulants is common after catheter ablation in older patients with atrial fibrillation.European heart journal open · 2026Article
- Article
- [Prognostic analysis of anticoagulation therapy in elderly patients with cardioembolic stroke].Beijing da xue xue bao. Yi xue ban = Journal of Peking University. Health sciences · 2026Article
- Compliance to direct oral anticoagulation therapy and clinical outcomes after catheter ablation for atrial fibrillation: a nationwide cohort study.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 · 2026Article
- Cost-Effectiveness Analysis of Patient Self-Management of Warfarin Among Patients With Non-Valvular Atrial Fibrillation.Pharmacotherapy · 2026Article
- Drug Adherence After Hospitalisation for Heart Failure: What Have We Learned from a French Survey?Journal of clinical medicine · 2026Article
- Drugs Don't Work in Patients Who Don't Take Them.JACC. Asia · 2026Article
- Clinical Event Rates and Patient Satisfaction with Generic Rivaroxaban in Atrial Fibrillation: The Prospective Guardian Study.TH open : companion journal to thrombosis and haemostasis · 2026Article
- Methods Article for a Study Protocol: Refining Stroke Prediction in Atrial Fibrillation Patients in an Ethnically Diverse Population - A Study Protocol.Neuroepidemiology · 2026Article
- Article
- 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
15 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionMedications cannot exert their effect if not taken as prescribed by patients. Our objective was to summarise the observational evidence on adherence to oral anticoagulants (OACs) among patients with atrial fibrillation (AF).
methodsIn March 2019, we systematically searched PubMed/Medline, Embase, CINAHL and PsycINFO (from inception) for observational studies measuring adherence, its determinants and impacts in patients with AF. Mean adherence measures and corresponding proportions of adherent patients were pooled using random effects models. Factors shown to be independently associated with adherence were extracted as well as the clinical and economic outcomes of adherence.
resultsWe included 30 studies. Pooled mean adherence scores of over half a million patients with AF 6 months and 1 year after therapy initiation were 77 (95% CI: 74-79) and 74 (68-79) out of 100, respectively. Drug-specific pooled mean adherence score at 6 months and 1 year were as follows: rivaroxaban: 78 (73-84) and 77 (69-86); apixaban: 77 (75-79) and 82 (74-89); dabigatran: 74 (69-79) and 75 (68-82), respectively. There was inadequate information on warfarin for inclusion in meta-analysis.Factors associated with increased adherence included: older age, higher stroke risk, once-daily regimen, history of hypertension, diabetes or stroke, concomitant cardiovascular medications, living in rural areas and being an experienced OAC user. Non-adherent patients were more likely to experience stroke and death, and incurred higher medical costs compared with patients with poor adherence.
conclusionsOur findings show that up to 30% of patients with AF are non-adherent, suggesting an important therapeutic challenge in this patient population.
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