Terra Mohamed, Badr Amro, Baklola Mohamed, Hegazy Ibrahim, Elmanzlawey Muhammed, Elrakhawy Islam, Muhammed Ahmed
Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Cardiovascular Department, Mayo Clinic, Phoenix, AZ, USA.
BMC Cardiovasc Disord. 2025 Feb 8;25(1):88. doi: 10.1186/s12872-024-04341-9.
Oral anticoagulant therapy (OAT) is critical for managing thromboembolic disorders, but adherence challenges significantly impact its effectiveness and patients' quality of life (QoL). This study explores the predictors of adherence and their effects on QoL among OAT users in Egypt.
This multi-center cross-sectional descriptive study with an analytical component was conducted at Mansoura University Hospital and Ain Shams University Hospital. Participants were adults over 18 years old, on OAT for at least one month, who provided informed consent. Convenience sampling was used to recruit 212 participants. Data were collected using a survey that included socio-demographic details, the Arabic Version of the Adherence to Refills and Medications Scale (ARMS), and the WHOQOL-BREF questionnaire. Statistical analyses included descriptive statistics, chi-square tests, Student's t-tests, and multivariate logistic regression.
The study included 212 participants, with an average age of 55 years, 57% female and 43% male. Among the participants, 25.5% were adherent to their anticoagulant regimen, while 74.5% were non-adherent. Adherence was significantly higher among NOAC users (44.4%) compared to warfarin users (19.0%). Key predictors of adherence included the use of NOACs (OR = 2.7), residency in rural areas (OR = 2.4), and having first-degree relatives in medical specialties (OR = 2.4). Quality of life scores were significantly higher for NOAC users in psychological, social, and environmental domains compared to warfarin users. The overall QoL score was also higher in NOAC users. Poorer adherence was associated with lower scores in these QoL domains.
Our study indicates that NOACs enhance adherence and quality of life relative to VKAs. Key adherence predictors include NOAC use, rural residency, and having relatives in medical professions. Educational level, initially significant, did not persist as a predictor in multivariate analysis. Targeted strategies are needed to improve adherence and patient outcomes.
口服抗凝治疗（OAT）对于管理血栓栓塞性疾病至关重要，但服药依从性方面的挑战显著影响其疗效以及患者的生活质量（QoL）。本研究探讨埃及口服抗凝治疗使用者的依从性预测因素及其对生活质量的影响。
本项具有分析性成分的多中心横断面描述性研究在曼苏拉大学医院和艾因夏姆斯大学医院开展。参与者为18岁以上、接受口服抗凝治疗至少1个月且签署知情同意书的成年人。采用便利抽样法招募了212名参与者。通过一项调查收集数据，该调查包括社会人口学详细信息、阿拉伯语版的药品续方和用药依从性量表（ARMS）以及世界卫生组织生活质量简表（WHOQOL - BREF）问卷。统计分析包括描述性统计、卡方检验、学生t检验和多因素逻辑回归。
该研究纳入了212名参与者，平均年龄为55岁，女性占57%，男性占43%。参与者中，25.5%的人坚持抗凝治疗方案，而74.5%的人未坚持。与华法林使用者（19.0%）相比，非维生素K拮抗剂（NOAC）使用者的依从性显著更高（44.4%）。依从性的关键预测因素包括使用NOAC（比值比[OR]=2.7）、居住在农村地区（OR = 2.4）以及有医学专业的一级亲属（OR = 2.4）。与华法林使用者相比，NOAC使用者在心理、社会和环境领域的生活质量得分显著更高。NOAC使用者的总体生活质量得分也更高。依从性较差与这些生活质量领域的得分较低相关。
我们的研究表明，相对于维生素K拮抗剂（VKA），NOAC可提高依从性和生活质量。依从性的关键预测因素包括使用NOAC、居住在农村地区以及有从事医疗行业的亲属。教育水平在最初具有显著性，但在多因素分析中不再作为预测因素持续存在。需要采取有针对性的策略来提高依从性和患者预后。
