Community pharmacy-based study of adherence to non-vitamin K antagonist oral anticoagulants

Andreas Capiau, Els Mehuys, Inge Van Tongelen, Thierry Christiaens, An De Sutter, Stephane Steurbaut, Souad Moudallel, Silas Rydant, Bernard Vrijens, Tine L M de Backer, Koen Boussery

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)

Abstract

OBJECTIVE: This study aimed to assess implementation adherence (how well the patient's actual intake matches the prescribed dosing regimen) to non-vitamin K antagonist oral anticoagulants (NOACs) and to explore experiences with and beliefs about NOACs in a real-world sample of long-term NOAC users.

METHODS: A cross-sectional observational study was conducted in home-dwelling adults who started taking a NOAC at least 1 year prior to inclusion. Pharmacy dispensing data were used to calculate the Medication Possession Ratio (MPR). Patients were recruited in 158 community pharmacies in Flanders, Belgium. They completed a questionnaire collecting basic characteristics and exploring self-reported adherence to NOACs (using the Medication Adherence Report Scale, MARS) and experiences with and beliefs about NOACs (using the Beliefs about Medicines Questionnaire, BMQ).

RESULTS: A total of 766 patients (mean age 76.2±8.8 years, median CHA2DS2-VASc score 4 (IQR=3-4)) were included. The majority (93.5%) used NOAC for stroke prevention in atrial fibrillation. The median MPR was 95.2% (IQR=87.8-99.7) which corresponds with half of the study population not taking their NOAC on at least 17 cumulative days per year. Almost 21% of participants reported non-adherence on the MARS (score <25), with unintentional non-adherence (forgetfulness) most frequently reported (15.4%). Although two-thirds of NOAC users indicated to experience adverse drug reactions, the BMQ demonstrated a positive attitude towards NOAC therapy, where necessity beliefs outweigh the concerns.

CONCLUSIONS: Our data indicate that long-term NOAC users have high implementation adherence and a positive attitude towards NOAC therapy. However, taking into account patients' thromboembolic risk and NOACs' short half-lives, further optimisation of NOAC use seems warranted in this population.

Original languageEnglish
Article numberheartjnl-2020-316781
Pages (from-to)1740-1746
Number of pages7
JournalHeart (British Cardiac Society)
Volume106
Issue number22
Early online date23 Jun 2020
DOIs
Publication statusPublished - Nov 2020

Bibliographical note

© Author(s) (or their employer(s)) 2020. No commercial re-use. See rights and permissions. Published by BMJ.

Fingerprint

Dive into the research topics of 'Community pharmacy-based study of adherence to non-vitamin K antagonist oral anticoagulants'. Together they form a unique fingerprint.

Cite this