Real‐World Adherence and Persistence with Direct Oral Anticoagulants in Adults with Atrial Fibrillation

• DOI: 10.1002/phar.1989
• Publication Date: 2017-07-21T08:45:55Z
• Authors: Beenish S. Manzoor; Todd A. Lee; Lisa K. Sharp; Surrey M. Walton; William L. Galanter; Edith A. Nutescu
• Keywords: Persistence (discontinuity); Medication Adherence; Health plan

Background Evidence of adherence and persistence patterns in anticoagulation ( AC ) therapy comparing treatment‐naïve non‐naïve patients is lacking. The objective this study was to evaluate medication a real‐world setting among ‐naïve ‐experienced with atrial fibrillation AF who were treated direct oral anticoagulants DOAC s). Methods newly initiating minimum 6 months continuous health plan enrollment pre postindex date (first prescription) identified from the Truven Health MarketScan Commercial Medicare Supplemental databases (2009–2013). (proportion days covered [ PDC ]), persistence, predictors assessed at 12 postindex. Results Of 66,090 included, 46.6% (n=30,826) naïve 53.4% (n=35,264) experienced (age: 66.9 ± 12.7 vs 70.4 11.4 yrs, p<0.001; male: n=19,132 [62.1%] n=21,691 [61.5%], p=0.14, respectively). A majority received dabigatran as their index (n=49,210; 74.5%). mean versus follow‐up 72.3% 83.3% (p<0.001) 63.7% 79.9% (p<0.001), respectively. Persistence ranged 59.3% 76.3% (p<0.0001) 31.6% 50.2% (p<0.0001), Predictors higher older age number concomitant medications. lower comorbidities user status. Conclusion Medication s declined over time both suboptimal (at mo postindex) compared patients. These findings can help target future strategies or interventions for patient education long‐term management especially those therapy. Future investigation should examine potential reasons differences between implications outcomes.