ArticlePharmacoepidemiology and drug safety2021
Adherence to direct oral anticoagulant treatment for atrial fibrillation in the Netherlands: A surveillance study.
Article in Pharmacoepidemiology and drug safety, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed, 13 citations in OpenAlex.
- The first month after direct oral anticoagulants: a window of vulnerability.Research and practice in thrombosis and haemostasis · 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
- Non-adherence and non-persistence of Direct Oral Anticoagulants among patients with non-valvular atrial fibrillation: a French retrospective cohort study.Scientific reports · 2025Article
- Effect of Previous INR Control during VKA Therapy on Subsequent DOAC Adherence and Persistence, in Patients Switched from VKA to DOAC.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
- 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
- Knowledge and medication adherence of oral anticoagulant-taking patients in Vietnam.Research and practice in thrombosis and haemostasis · 2023Article
- Adherence to direct oral anticoagulant treatment for atrial fibrillation in the Netherlands: A surveillance study.Pharmacoepidemiology and drug safety · 2021Article
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Authors and funding
9 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAdherence to direct oral anticoagulants (DOACs) in patients with atrial fibrillation in every day practice may be less than in clinical trials.
aimsTo assess adherence to DOACs in atrial fibrillation patients in every day practice and identify predictors for non-adherence.
methodsIndividual linked dispensing data of atrial fibrillation patients who used DOACs were obtained from the Foundation for Pharmaceutical Statistics covering the Netherlands between 2012 and 2016. One year adherence to DOAC was calculated for initial DOAC as proportion of days covered (PDC) ≥80% and the association between clinical variables and adherence was assessed using logistic regression. In addition, we measured non-persistence, that is, patients who completely stopped their initial DOAC within 1 year follow-up.
resultsA total of 4797 apixaban-, 20 454 rivaroxaban- and 18 477 dabigatran users were included. The mean age was 69 years (n = 43 910), which was similar for the DOAC types. The overall proportion of patients with PDC ≥80% was 76%, which was highest for apixaban- (87%), followed by dabigatran- (80%) and rivaroxaban (69%) users. Multivariable analyses revealed that age ≤60 years, no concomitant drug use were predictors for non-adherence. Of atrial fibrillation patients who continued treatment, 97% had a PDC ≥80%, compared with only 56% for those who discontinued their DOAC treatment within 1 year.
conclusionsNon-adherence to DOACs was associated with age ≤60 years and no concomitant drugs use. Non-adherence was higher in patients who later discontinued DOAC treatment. Results of our study support research into interventions to improve adherence.
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