Research Group Clinical Pharmacology and Clinical Pharmacy, Vrije Universiteit Brussel, Brussel, Belgium.
Research Group of Biostatistics and Medical Informatics, Department of Public Health (GEWE), Vrije Universiteit Brussel, Brussel, Belgium.
Br J Clin Pharmacol. 2022 May;88(5):2419-2429. doi: 10.1111/bcp.15180. Epub 2022 Jan 10.
Direct oral anticoagulants (DOACs) are increasingly used for stroke prevention in atrial fibrillation. However, little is known about the association between medication adherence, patient satisfaction and treatment knowledge. The objective was to determine patients' DOAC adherence and their treatment satisfaction over time. Furthermore, we respectively investigated possible associations of treatment satisfaction and treatment knowledge in relation to adherence.
Longitudinal study conducted in atrial fibrillation patients hospitalized in 2019 in a tertiary university hospital. DOAC adherence, treatment satisfaction and knowledge were assessed with validated questionnaires. Mixed effects logistic regression was modelled to investigate the effect of both treatment satisfaction and knowledge on DOAC adherence over time.
In total, 164 patients participated of whom 128 and 101 patients could be recontacted after a period of, respectively, 3 (first contact) and 6 months (second contact) to assess adherence and treatment satisfaction. Suboptimal adherence was observed in 40.6% of the patients after 3 months and in 42.6% after 6 months (P = .78). There was no significant difference (P = .29) in the total score for treatment satisfaction between the first (79.2%) and the second contact (80.6%). DOAC adherence was not affected by time (P = .71) nor by total knowledge score (P = .61) or treatment satisfaction score (P = .34). Nonetheless, a strong correlation between treatment satisfaction and knowledge was found (P = .004).
DOAC adherence was suboptimal. Treatment satisfaction and knowledge were not associated with DOAC adherence over a 6-month period. Knowledge gaps were identified that could be remediated through patient education and follow-up.
直接口服抗凝剂（DOACs）越来越多地用于预防房颤患者的中风。然而，对于药物依从性、患者满意度和治疗知识之间的关系知之甚少。本研究的目的是确定患者 DOAC 依从性及其随时间推移的治疗满意度。此外，我们分别调查了治疗满意度和治疗知识与依从性相关的可能关联。
这是一项在 2019 年在一家三级大学医院住院的房颤患者中进行的纵向研究。使用经过验证的问卷评估 DOAC 依从性、治疗满意度和知识。采用混合效应逻辑回归模型，研究治疗满意度和知识随时间推移对 DOAC 依从性的影响。
共有 164 名患者参与，其中 128 名和 101 名患者在分别经过 3 个月（第一次接触）和 6 个月（第二次接触）的时间后可以重新联系，以评估依从性和治疗满意度。3 个月后，40.6%的患者依从性不理想，6 个月后，42.6%的患者依从性不理想（P = .78）。第一次（79.2%）和第二次接触（80.6%）之间的治疗满意度总评分没有显著差异（P = .29）。DOAC 依从性不受时间（P = .71）、总知识评分（P = .61）或治疗满意度评分（P = .34）的影响。尽管如此，治疗满意度和知识之间存在很强的相关性（P = .004）。
DOAC 依从性不理想。治疗满意度和知识与 6 个月期间的 DOAC 依从性无关。确定了知识差距，可以通过患者教育和随访来弥补这些差距。
