Predictors of anticoagulation adherence in patients with acute pulmonary embolism

• DOI: 10.1016/j.tru.2022.100100
• Publication Date: 2022-01-19T17:10:29Z
• Authors: Karim Merchant; Parth V. Desai; Stephen Morris; Sovik De Sirkar; Dalila Masic; Parth Shah; Nicolas Krepostman; Matthew Collins; Kevin Walsh; Nathalie Antonios; Lucas Chan; Sorcha Allen; Ahmad Manshad; Shannon Kuhrau; Alexandru Marginean; Ahmed Elkaryoni; Jawed Fareed; Yevgeniy Brailovsky; Amir Darki
• Keywords: Apixaban

Anticoagulation (AC) adherence after acute pulmonary embolism (PE) is vital to prevent mortality and future recurrence of venous thromboembolism (VTE). We aimed analyze factors affecting AC PE. Consecutive adult patients with CT angiography or V/Q scan confirmed PE were included in a single-center retrospective study from April 2016 May 2020. Adherence data, including refill dates, collected pharmacies, measures Continuous Measure Medication Acquisition (CMA), Proportion Days Covered (PDC), Optimal (OMA) calculated per standardized formulas. Univariable multivariable linear logistic regression was used different variables adherence. A total 118 out 144 had sufficient follow-up data measure the final analysis. Mean age 60 ± 15 years, 64 (54.2%) women; 70 (59.3%) White, 26 (22%) African American, 13 (11%) Hispanic; 58 (49.2%) private insurance, 48 (40.7%) Medicare, 11 (9.3%) Medicaid. Type comprised 57 (48.3%) apixaban, 17 (14.4%) rivaroxaban, 8 (6.8%) warfarin, 6 (5.1%) enoxaparin, 30 (25.4%) changing AC. In univariable regression, American Medicaid-insured significantly lower adherence, while advancing age, apixaban usage, 30-day clinic visit showed higher However, race (PDC -0.135, p = 0.006, CI (−0.231, −0.040) | OMA Adjusted OR 0.166, 0.030, (0.033, 0.837)) other non-White, non-Hispanic races -0.314, 0.009, (−0.548, −0.080)) associated our study, minority hospital admission for Further studies are needed address underlying contributors improve this population.