Evidence map›Paper›PMID 37831125›Full record

Trial reportJournal of neurology2024

Intake reminders are effective in enhancing adherence to direct oral anticoagulants in stroke patients: a randomised cross-over trial (MAAESTRO study).

Fine Dietrich, Alexandros A Polymeris, Valerie Albert, Stefan T Engelter, Kurt E Hersberger, Sabine Schaedelin, Philippe A Lyrer, Isabelle Arnet

Registry-linked trialOpen access · hybridAbstract readRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of neurology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03344146 (Electronic Monitoring and Improvement of Adherence to Direct Oral Anticoagulant Treatment - a Randomised Crossover Study of an Educational and Reminder-based Intervention in Ischaemic Stroke Patients Under Polypharmacy), which is not on this map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
1.8field-weighted citation impact, top 14% 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.

NCT03344146 nacompletednot on this map

Electronic Monitoring and Improvement of Adherence to Direct Oral Anticoagulant Treatment - a Randomised Crossover Study of an Educational and Reminder-based Intervention in Ischaemic Stroke Patients Under Polypharmacy

TypeinterventionalSponsorUniversity Hospital, Basel, SwitzerlandRan2017 to 2022Enrolled130ConditionsAdherence, Patient, Stroke, IschemicArmsMedication intake reminders, Pillbox use and counselling
3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 7 citations in OpenAlex.

  1. Trial
  2. Trial
  3. 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

8 authors at 1 institution in 1 country.

Fine Dietrich *Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056, Basel, Switzerland. fine.dietrich@unibas.ch.ORCID http://orcid.org/0000-0002-0672-6879
Alexandros A Polymeris *Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Petersgraben 4, 4051, Basel, Switzerland.
Valerie AlbertPharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056, Basel, Switzerland.
Stefan T EngelterDepartment of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Petersgraben 4, 4051, Basel, Switzerland.
Kurt E HersbergerPharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056, Basel, Switzerland.
Sabine SchaedelinClinical Trial Unit, Department of Clinical Research, University Hospital Basel and University of Basel, Schanzenstrasse 55, 4056, Basel, Switzerland.
Philippe A Lyrer *Department of Neurology and Stroke Centre, University Hospital Basel and University of Basel, Petersgraben 4, 4051, Basel, Switzerland.
Isabelle Arnet *Pharmaceutical Care Research Group, Department of Pharmaceutical Sciences, University of Basel, Klingelbergstrasse 50, 4056, Basel, Switzerland.
University of Basel · CH

Funding

Swiss Academy of Medical Sciences and the Bangerter-Foundation YTCR 31/17
6 · The paper itself

Abstract

backgroundDirect oral anticoagulants (DOAC) effectively prevent recurrent ischaemic events in atrial fibrillation (AF) patients with recent stroke. However, excellent adherence to DOAC is mandatory to guarantee sufficient anticoagulation as the effect quickly subsides.

aimTo investigate the effect of intake reminders on adherence to DOAC.

methodsMAAESTRO was a randomised, cross-over study in DOAC-treated AF patients hospitalised for ischaemic stroke. Adherence was measured by electronic monitoring for 12 months. After an observational phase, patients were randomised to obtain an intake reminder either in the first or the second half of the subsequent 6-month interventional phase. The primary outcome was 100%-timing adherence. Secondary outcomes were 100%-taking adherence, and overall timing and taking adherence. We analysed adherence outcomes using McNemar's test or mixed-effects logistic models.

resultsBetween January 2018 and March 2022, 130 stroke patients were included, of whom 42 dropped out before randomisation. Analysis was performed with 84 patients (mean age: 76.5 years, 39.3% women). A 100%-timing adherence was observed in 10 patients who were using the reminder, and in zero patients without reminder (p = 0.002). The reminder significantly improved adherence to DOAC, with study participants having 2.7-fold increased odds to achieve an alternative threshold of 90%-timing adherence (OR 2.65; 95% CI 1.05-6.69; p = 0.039). A similar effect was observed for 90%-taking adherence (OR 3.06; 95% CI 1.20-7.80; p = 0.019). Overall timing and taking adherence increased significantly when using the reminder (OR 1.70; 95% CI 1.55-1.86, p < 0.01; and OR 1.67; 95% CI 1.52-1.84; p < 0.01).

conclusionIntake reminders increased adherence to DOAC in patients with stroke attributable to atrial fibrillation.

trial registrationClinicalTrials.gov: NCT03344146.

Indexed as

AnticoagulantsStrokeAdministration, OralAgedAtrial FibrillationBrain IschemiaCross-Over StudiesFemaleHumansMaleAnticoagulantsAtrial fibrillationDirect oral anticoagulantsIschaemic strokeMedication adherenceStroke

Identifiers

PMID37831125
PMCPMC10827905
OpenAlexW4387598703

What OpenQuestion holds

Textmetadata
LicenceCC BY
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Registered trials

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.