Author + information
- Han-Jun Baea,b,
- Seongwook Hana,b,
- Sanghun Leea,b,
- Yun-Kyeong Choa,b,
- Yoon-Nyun Kima,b,
- Hyoung-Seob Parka,b and
- Hyungseop Kima,b
Background: Non-vitamin K antagonist (VKA) oral anticoagulants (NOACs) have emerged as an alternative to VKA for thrombophylaxis. NOACs require a stricter medication adherence because NOACs have a much shorter half-life, and the direct measurement of the NOAC activity in clinical practice is impractical. Information on the degree of adherence to NOACs is limited in the real world. We investigated the medication adherence in real world patients who were on NOACs in a Korean Tertiary Referral Center.
Methods: We enrolled 722 consecutive patients who were prescribed NOACs for nonvalvular atrial fibrillation in the cardiology department from May 2016 to September 2016. All patients who had an appointment the day before were screened, and the patients on NOACs were contacted by phone or text to tell them to bring their remaining pills without telling them why. The maximum duration of the prescription was four months at this institution without refills. Adherence was measured by the pill count (number of doses taken/number of doses dispensed from the last prescription X 100 [%]) and Morisky Medication Adherence Scale (MMAS)-8. All 4 NOACs (apixaban 47.8%, dabigatran 21.2%, rivaroxaban 18.4%, and edoxaban 12.6%) had been prescribed.
Results: The mean duration that the patients were taking NOACs was 7.2±5.7 months. The mean adherence was 94.0±11.8%. The mean MMAS was 2.6±0.8. There was a significant difference in the adherence between once daily vs. twice daily dosing (95.4±9.1% vs. 93.4±12.7% P=0.032). However, the difference was clinically irrelevant. The proportion of an adherence of < 82% (1 standard deviation of the mean) was 27.7% in patients with an MMAS score >2, and 6.3% in those with an MMAS score ≤2 (P=0.000).
Conclusions: Most patients who were taking NOACs had an excellent adherence in the real world practice in Korea. An MMAS >2 could be used as a surrogate marker for a relatively poor adherence to NOACs.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Arrhythmias and Clinical EP: Anticoagulation Issues
Abstract Category: 6. Arrhythmias and Clinical EP: Other
Presentation Number: 1189-086
- 2017 American College of Cardiology Foundation