Electronic monitoring of adherence to once‐daily and twice‐daily direct oral anticoagulants in patients with atrial fibrillation: Baseline data from the SMAAP‐AF trial

Journal of Arrhythmia

the SMAAP‐AF investigators¹  Fumiaki Mori²  Yoichi Ajiro²  Kazunori Iwade²  Emi Sawada³  Tsuyoshi Shiga³  Nobuhisa Hagiwara³  Shoji Haruta⁴  Yuichiro Yamada⁴  Toshimi Kimura⁵  Noritoshi Fukushima⁶  Yuji Yoshiyama⁷ 

[1] ;Department of Cardiology National Hospital Organization Yokohama Medical Center Yokohama Japan;Department of Cardiology Tokyo Women’s Medical University Tokyo Japan;Department of Cardiology Tokyo Women’s Medical University Yachiyo Medical Center Yachiyo Japan;Department of Pharmacy Tokyo Women’s Medical University Hospital Tokyo Japan;Department of Preventive Medicine and Public Health Tokyo Medical University Tokyo Japan;Kitasato University School of Pharmacy Tokyo Japan;

关键词: adherence;    atrial fibrillation;    direct oral anticoagulant;    dosing frequency;    electronic monitoring;   

DOI  :  10.1002/joa3.12532

来源: DOAJ

【 摘 要 】

Abstract Background Nonadherence diminishes the efficacy of direct oral anticoagulants (DOACs) in patients with nonvalvular atrial fibrillation (NVAF). This report presents the baseline survey results regarding medication adherence among NVAF patients who were treated with once‐daily edoxaban or twice‐daily apixaban from a randomized control trial of the effect of an educational intervention on DOAC adherence. Methods We prospectively studied 301 NVAF patients who were treated with edoxaban (n = 175) or apixaban (n = 126) during the 12‐week observation period. Adherence was measured with an electronic monitoring system and is expressed as the percentage of days with the correct doses in the measurement period (days). Adherence to DOAC therapy was defined based on the standard threshold (≥80%) or a strict threshold (≥90%). Results Of the 301 patients, 33 had incomplete data or protocol deviations, leaving 268 patients (edoxaban 158 and apixaban 110) for the per‐protocol baseline analysis. There was no difference in adherence (threshold ≥80%) between the groups (edoxaban 95% vs apixaban 91%, P = .2), but there was a lower proportion of patients with strict adherence (threshold ≥90%) among apixaban users than among edoxaban users (edoxaban 87% vs apixaban 76%, P = .02). Multivariate analysis showed a negative relationship between apixaban use and an adherence rate ≥90% (odds ratio 0.49, 95% confidence interval [CI]: 0.25‐0.94). Conclusions Our study showed that the proportion of DOAC users with adherence (≥80%) did not differ between the groups, but the proportion of patients with strict adherence (≥90%) was lower among those using apixaban than among those using edoxaban.

【 授权许可】

Unknown