Evidence map›Paper›PMID 36604126›Full record

ArticleBMJ open2023

Comparison of medication adherence to different oral anticoagulants: population-based cohort study.

Arnar B Ingason, Jóhann P Hreinsson, Sigrún H Lund, Arnar S Ágústsson, Edward Rumba, Daníel A Pálsson, Indriði E Reynisson, Brynja R Guðmundsdóttir, Páll T Önundarson, Einar S Björnsson

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

Article in BMJ open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
2.0field-weighted citation impact, top 13% 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

7 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
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

10 authors at 3 institutions in 1 country.

Arnar B IngasonFaculty of Medicine, University of Iceland, Reykjavik, Iceland arnarbingason@gmail.com.ORCID 0000-0003-0943-2523
Jóhann P HreinssonDepartment of Molecular and Clinical Medicine, Sahlgrenska Academy, Goteborg, Sweden.
Sigrún H LundDeCODE Genetics, Reykjavik, Iceland.
Arnar S ÁgústssonFaculty of Medicine, University of Iceland, Reykjavik, Iceland.
Edward RumbaFaculty of Medicine, University of Iceland, Reykjavik, Iceland.
Daníel A PálssonFaculty of Medicine, University of Iceland, Reykjavik, Iceland.
Indriði E ReynissonFjordur Health Care Center, Hafnarfjordur, Iceland.
Brynja R GuðmundsdóttirDepartment of Laboratory Hematology, Landspitali University Hospital, Reykjavik, Iceland.
Páll T ÖnundarsonFaculty of Medicine, University of Iceland, Reykjavik, Iceland.
Einar S BjörnssonFaculty of Medicine, University of Iceland, Reykjavik, Iceland.
Reykjavík University · ISdeCODE Genetics (Iceland) · ISUniversity Centre of the Westfjords · IS

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivePrevious observational studies have yielded conflicting results on whether medication adherence differs between patients receiving warfarin and direct oral anticoagulants (DOACs). Importantly, no study has adequately accounted for warfarin dosing being continuously modified based on INR values while dosing of DOACs is fixed. We aimed to compare non-adherence between new users of apixaban, dabigatran, rivaroxaban and warfarin in a population-based cohort.

methodsNew users of apixaban, dabigatran, rivaroxaban and warfarin from 2014 to 2019 living in the Icelandic capital area were included. Non-adherence was defined as proportion of days covered below 80%. Inverse probability weighting was used to yield balanced study groups and non-adherence was compared using logistic regression. Factors associated with non-adherence were estimated using multivariable logistic regression.

resultsOverall, 1266 patients received apixaban, 247 dabigatran, 1566 rivaroxaban and 768 warfarin. The proportion of patients with non-adherence ranged from 10.5% to 16.7%. Dabigatran was associated with significantly higher odds of non-adherence compared with apixaban (OR 1.57, 95% CI 1.21 to 2.04, p<0.001), rivaroxaban (OR 1.45, 95% CI 1.12 to 1.89, p=0.005) and warfarin (OR 1.63, 95% CI 1.23 to 2.15, p<0.001). The odds of non-adherence were similar for apixaban, rivaroxaban and warfarin. Apart from the type of oral anticoagulants (OACs) used, female sex, hypertension, history of cerebrovascular accident and concomitant statin use were all independently associated with lower odds of non-adherence.

conclusionDabigatran was associated with higher odds of non-adherence compared with other OACs. Non-adherence was similar between apixaban, rivaroxaban and warfarin users. Female sex and higher comorbidity were associated with better medication adherence.

Indexed as

Atrial FibrillationStrokeAdministration, OralAnticoagulantsCohort StudiesDabigatranFemaleHumansMedication AdherencePyridonesRetrospective StudiesRivaroxabanWarfarinAnticoagulantsDabigatranPyridonesRivaroxabanWarfarinanticoagulationclinical pharmacologyquality in health carerisk management

Identifiers

PMID36604126
PMCPMC9827257
OpenAlexW4313550009

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.