Department of Medical Science and Public Health, University of Cagliari, Italy; SHRO, Temple University, Philadelphia, PA, USA.
AOU, Cagliari, Italy.
Int J Cardiol. 2021 Jun 15;333:162-166. doi: 10.1016/j.ijcard.2021.03.003. Epub 2021 Mar 8.
Patient's adherence to oral anticoagulant therapy is essential to prevent and treat thrombotic events.
To assess the patients' adherence Morisky Medication Adherence Scale 8-items was used. The target population included 785 consecutive outpatients, of whom 384 were on Vitamin K Antagonists and 401 on Direct Oral Anticoagulants. Moreover, we evaluate which variable among age, gender, having experienced a thrombotic episode, time in the therapeutic range for patients on Vitamin K Antagonists, being naive and once versus twice daily drug assumption for patients on Direct Oral Anticoagulants, could affect adherence to therapy.
Morisky Medication Adherence Scale 8-items score was 8 in both groups. The intentional non-adherence obtained the lowest score while the unintentional non-adherence is the most frequent problem in patients treated with either Vitamin K Antagonists or Direct Oral Anticoagulants. Age > 75 years, male gender, having experienced a thrombotic episode, being naive and assuming Direct Oral Anticoagulants twice a day were significantly associated with a higher risk to forget assuming the oral anticoagulant, to have more difficulty in remembering to take it or to bring it in case of travel or leaving home. A low percentage of time in therapeutic range was associated with a not regularly assumption of the anticoagulants.
Patients treated with Vitamin K Antagonists or Direct Oral Anticoagulants show a good adherence and persistence to their oral anticoagulant therapy. Several factors have been identified to affect patients' adherence and deserve a careful attention by the doctors at the Anticoagulation Clinic.
患者对口服抗凝治疗的依从性对于预防和治疗血栓事件至关重要。
采用 Morisky 药物依从性量表 8 项来评估患者的依从性。目标人群包括 785 名连续门诊患者，其中 384 名服用维生素 K 拮抗剂，401 名服用直接口服抗凝剂。此外，我们评估了年龄、性别、是否经历过血栓事件、维生素 K 拮抗剂患者的治疗范围内时间、是否为初治以及直接口服抗凝剂患者每日一次或两次服药假设等变量，这些变量可能会影响治疗的依从性。
两组的 Morisky 药物依从性量表 8 项评分均为 8 分。故意不依从的得分最低，而无意不依从是接受维生素 K 拮抗剂或直接口服抗凝剂治疗的患者最常见的问题。年龄>75 岁、男性、经历过血栓事件、初治以及每日两次服用直接口服抗凝剂与更高的遗忘服用口服抗凝剂、更难记住服用或在旅行或离家时携带口服抗凝剂的风险相关。治疗范围内的时间比例低与抗凝剂不规则服用相关。
接受维生素 K 拮抗剂或直接口服抗凝剂治疗的患者对其口服抗凝治疗具有良好的依从性和持久性。已经确定了一些因素会影响患者的依从性，这需要抗凝门诊医生的密切关注。
