Song Ting, Xin Xiao, Cui Peirong, Zong Mingcan, Li Xianhua
School of Nursing, Shanghai Jiaotong University, Shanghai, People's Republic of China.
Department of Oncology, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, People's Republic of China.
Patient Prefer Adherence. 2021 Mar 1;15:493-500. doi: 10.2147/PPA.S285020. eCollection 2021.
Inadequate medication adherence among patients with non-valvular atrial fibrillation (NVAF) will directly affect the efficacy and safety of anticoagulation therapy, leading to a considerable increase in the risk of ischemic stroke and death. In this study, we aim to investigate medication adherence and identify the influencing factors, including social-demographic, disease-related information and self-efficacy.
We recruited 170 patients with NVAF from a tertiary hospital atrial fibrillation outpatient clinics and cardiology ward from June 2020 to September 2020. Patients who had been taking oral anticoagulation medication for at least 3 months were included. And Morisky medication adherence scale (MGL) was used to assess the adherence to anticoagulants, which scores <4 were considered as low adherence.
Fifty (29.4%) NVAF patients had a MGL score<4. Monthly income, types of comorbidities, number of drugs, and self-efficacy were determinants of anticoagulation adherence. Binomial logistic regression showed that patients had been prescribed more durgs (OR: 3.51, p=0.002), had high monthly income (OR: 7.87, p=0.001), without other diseases (OR: 8.00, p=0.005), and with higher self-efficacy (OR: 1.42, p=0.001) showed high adherence.
Number of drugs, types of comorbidities, monthly income, and self-efficacy were associated with the adherence of non-vitamin K antagonist oral anticoagulants (NOACs).
非瓣膜性心房颤动（NVAF）患者抗凝治疗依从性不佳将直接影响抗凝治疗的疗效和安全性，导致缺血性卒中风险和死亡风险显著增加。在本研究中，我们旨在调查药物治疗依从性并确定影响因素，包括社会人口统计学、疾病相关信息和自我效能感。
我们于2020年6月至2020年9月从一家三级医院的心房颤动门诊和心内科病房招募了170例NVAF患者。纳入至少服用口服抗凝药物3个月的患者。采用Morisky药物治疗依从性量表（MGL）评估抗凝药物依从性，得分<4分被视为低依从性。
50例（29.4%）NVAF患者的MGL得分<4分。月收入、合并症类型、药物数量和自我效能感是抗凝治疗依从性的决定因素。二项逻辑回归显示，服用更多药物（比值比：3.51，p = 0.002）、月收入高（比值比：7.87，p = 0.001）、无其他疾病（比值比：8.00，p = 0.005）以及自我效能感较高（比值比：1.42，p = 0.001）的患者依从性较高。
药物数量、合并症类型、月收入和自我效能感与非维生素K拮抗剂口服抗凝药（NOACs）的依从性相关。
