Evidence map›Paper›PMID 34498537›Full record

ArticleAnnals of medicine2021

Adherence to oral anticoagulation in ischemic stroke patients with atrial fibrillation.

Paula Tiili, Ioannis Leventis, Janne Kinnunen, Ida Svedjebäck, Mika Lehto, Efstathia Karagkiozi, Dimitrios Sagris, George Ntaios, Jukka Putaala

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Annals of medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
1.6field-weighted citation impact, top 15% of its field
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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Prevalence and Predictors of Non-adherence to Oral Anticoagulation Therapy Up To 24 Months After Acute Pulmonary Embolism: Results from a Prospective Observational Study.Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis
    Observational
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

9 authors at 4 institutions in 3 countries.

Paula TiiliDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Ioannis LeventisDepartment of Internal Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
Janne KinnunenDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Ida SvedjebäckDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
Mika LehtoLohja Hospital, Department of Internal Medicine, Helsinki, Finland.
Efstathia KaragkioziDepartment of Internal Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
Dimitrios SagrisDepartment of Internal Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
George NtaiosDepartment of Internal Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece.
Jukka PutaalaDepartment of Neurology, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.
University of Thessaly · GRHelsinki University Hospital · FIS.L. Raheja Hospital · INUniversity of Helsinki · FI

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNon-vitamin K antagonist oral anticoagulants (NOAC) have superior safety and comparable efficacy profile compared to vitamin-K antagonists (VKAs), with more convenient dosing schemes. However, issues with adherence to the NOACs remain unsolved.

aimsWe sought to investigate the adherence to oral anticoagulation (OAC) and baseline factors associated with poor adherence after ischaemic stroke in patients with atrial fibrillation (AF).

methodsWe recruited hospitalised patients (2013-2019) from two prospective stroke registries in Larissa and Helsinki University Hospitals and invited survived patients to participate in a telephone interview. We assessed adherence with the Adherence to Refills and Medications Scale (ARMS) and defined poor adherence as a score of over 17. In addition to demographics, individual comorbidities, and stroke features, we assessed the association of CHA

resultsAmong 396 patients (median age 75.0 years, interquartile range [IQR] 70-80; 57% men; median time from ischaemic stroke to interview 21 months [IQR 12-33]; median ARMS score 17 [IQR 17-19]), 56% of warfarin users and 44% of NOAC users reported poor adherence. In the multivariable regression model adjusted for site, sex, and age, poor adherence was independently associated with tertiary education, absence of heart failure, smoking history, use of VKA prior to index stroke, and prior ischaemic stroke. CHA

conclusionsAdherence was poor in half of AF patients who survived an ischaemic stroke. Independent patient-related factors, rather than composite scores, were associated with poor adherence in these patients.KEY MESSAGESAdherence was poor in half of the atrial fibrillation patients who survived an ischaemic stroke.Independent patient-related factors rather than composite scores were associated with poor adherence.The findings support the importance of recognising adherence support as a crucial part of holistic patient care recommended by recent AF guideline.

Indexed as

Administration, OralAnticoagulantsAtrial FibrillationBrain IschemiaChildChild, PreschoolFemaleHumansIschemic StrokeMaleMedication AdherenceProspective StudiesStrokeAnticoagulantsadherenceAtrial fibrillationischaemic strokeoral anticoagulationpersistence

Identifiers

PMID34498537
PMCPMC8439221
OpenAlexW3198784418

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

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.