Assessing adherence to direct oral anticoagulants (DOACs) among patients with atrial fibrillation in tertiary-care referral centers in Malaysia
INTRODUCTION Direct oral anticoagulants (DOACs), such as dabigatran and rivaroxaban, are now available for stroke prevention in patients with atrial fibrillation (AF) and are often clinically preferred over vitamin K antagonists (VKAs), such as warfarin. Data describing adherence to DOACs in real-...
| Main Authors: | , , , , , , |
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| Format: | Conference or Workshop Item |
| Language: | English English English |
| Published: |
2019
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| Subjects: | |
| Online Access: | http://irep.iium.edu.my/75874/ http://irep.iium.edu.my/75874/1/191104_main%20page_program.pdf http://irep.iium.edu.my/75874/2/191104_kubas_poster_program.pdf http://irep.iium.edu.my/75874/3/191015_poster%20icprp_Kubas_ICPRP_A0_v05.pdf |
| Summary: | INTRODUCTION
Direct oral anticoagulants (DOACs), such as dabigatran and rivaroxaban, are now available for stroke prevention
in patients with atrial fibrillation (AF) and are often clinically preferred over vitamin K antagonists (VKAs), such as warfarin. Data describing adherence to DOACs in real-life clinical practice in Malaysia are scarce.
OBJECTIVES
This study aimed to assess adherence to DOACs in patients with AF at Hospital Kuala Lumpur (HKL) and
Hospital Serdang (HSDG), tertiary-care referral centers.
METHODOLOGY
This was a retrospective cohort study that included all AF patients who were treated with DOACs (dabigatran or
rivaroxaban) in HKL and HSDG. Data were obtained from medical records and pharmacy database. Adherence
was assessed by using proportion of days covered (PDC) over a 1-year duration and was calculated as the
number of days that the medication was on hand over the total number of days in the time period. Good adherence was defined as PDC ≥80%
RESULTS
There were 281 patients who met the inclusion criteria, male 54.1% (n=152), with 75.1% (n=211) patients on
dabigatran and others on rivaroxaban. The ethnic distribution was Chinese 49.8% (n=140), Malay 41.6% (n=117), and Indian 8.5% (n=24). Only 66.9% of patients achieved good adherence with PDC ≥ 80%. Adherence by institution was good in HKL with 85.2% (n=69/81) but poor in HSDG with 59.5% (n=119/200) [p<0.05].
CONCLUSION
Overall adherence to DOACs was poor but it varied between institutions, potentially due to institution-specific
administrative and clinical practice differences. Clinical care can potentially be optimized by identifying factors affecting adherence and implementing adherence-improving interventions. |
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