HealthDay News – Patients with atrial fibrillation (AF) cite multiple reasons for not following direct-acting oral anticoagulant (DOAC) therapy, according to a study published online Aug. 27 in the Journal of the American Geriatrics Society.
Derjung M. Tarn, MD, Ph.D., of the University of California at Los Angeles, and colleagues attempted semi-structured telephone interviews with 42 patients to understand why patients with AF do not adhere to apixaban, the most commonly prescribed DOAC. with documented non-adherence to apixaban.
The researchers found that 35 of 42 patients started apixaban but stopped, skipped, or reduced dosing, while the remaining seven patients never started apixaban. Six main issues related to non-adherence arose including cost (two-thirds), bleeding (either fear of or experience with), lack of AF symptoms, belief that it is safe to skip doses, confusion about measurable effects, and incomplete or ambiguous patient – doctor communication. In addition, some patients started taking alternative or natural treatments instead of apixaban.
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“In summary, this study describes patient-reported reasons underlying DOAC apixaban non-compliance, including cost, bleeding concerns, uncertainty about the need for anticoagulation, and the belief that dose skipping is trivial,” the authors write. “Patients didn’t always tell their doctors about their non-compliance. This work identifies goals for interventions to increase adherence. “
Bristol-Myers Squibb and Pfizer funded the study; Pfizer makes apixaban.
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Subjects:
Atrial fibrillation General cardiac stroke treatments
