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Low Adherence to All Oral Anticoagulants the Norm in Atrial Fib

Fewer than half of patients with atrial fibrillation adhere to their anticoagulant regimen in a real clinical-practice setting, even if prescribed one of the new oral anticoagulants (NOACs) rather than a vitamin-K antagonist such as warfarin, a cohort study suggests. The NOACs have been touted as more convenient to take, and adherence to them was better than warfarin adherence in the retrospective analysis, but there was still a substantial shortfall.

The investigators used administrative claims from a large US insurance database to identify 64,661 patients with AF who had initiated treatment with warfarin or one of three NOACs between November 2010 and December 2014. At the yearlong median follow-up, 47.5% of patients taking one of the NOACs had adhered to treatment for 80% or more of the study interval. That was modestly although signifcantly better than adherence among patients taking warfarin, in whom just 40.2% had 80% or more days covered by anticoagulation (P<0.001).

The report was published in the February 2016 issue of the Journal of the American Heart Association.