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Title: | Adherence to oral anticoagulation measured by electronic monitoring in a Belgian atrial fibrillation population | Authors: | KNAEPEN, Lieselotte DELESIE, Michiel VIJGEN, Johan DENDALE, Paul Ector, Joris DESTEGHE, Lien HEIDBUCHEL, Hein |
Issue Date: | 2023 | Publisher: | SPRINGER HEIDELBERG | Source: | Clinical Research in Cardiology, 112, p. 1812–1823 | Abstract: | Introduction Stroke prevention using oral anticoagulation (OAC) is the first management priority in atrial fibrillation (AF). Despite the importance of good therapy adherence, real-world adherence is still suboptimal. Patient education and adherence monitoring with new technologies are recommended. The main purpose of this sub-analysis of the AF-EduCare trial was to evaluate the effect of personalized follow-up strategies on adherence to OAC. Methods Regimen adherence was monitored by the electronic Medication Event Monitoring System cap at the start of the trial (M1) and after 12 months (M2), each for three months. Patients were part of one of three education groups (In-person, Online or App-based) or the standard care (SC) group. All are qualified for OAC therapy. Results A total of 768 patients were evaluated ( 11.8% SC vs. 86.8% any education group, mean age: 70.1 +/- 7.9 years). Patients were taking non-vitamin K OAC (once daily 53.8%; twice daily 35.9%) or vitamin K antagonists (9.4%), equally distributed over the different study arms (p = 0.457). Mean therapy adherence was high (M1:93.8 +/- 10.8%; M2:94.1 +/- 10.1%). During both monitoring periods, the education group scored significantly higher than SC (M1:94.2 +/- 10.0% vs. 91.3 +/- 15.0%; p = 0.027; M2:94.4 +/- 9.3% vs. 91.6 +/- 14.0%; p = 0.006). More patients in the In-person and Online groups were able to keep or improve their adherence to > 90% compared to the SC. Conclusion Overall adherence to OAC in all study groups, even in SC, was very high, without attrition over time. Nevertheless, targeted education led to a small but significantly improved adherence compared to SC. | Notes: | Knaepen, L (corresponding author), Antwerp Univ Hosp, Drie Eikenstr 655, B-2650 Edegem, Belgium.; Knaepen, L (corresponding author), Univ Antwerp, Res Grp Cardiovasc Dis, Prinsstr 13, B-2000 Antwerp, Belgium.; Knaepen, L (corresponding author), Hasselt Univ, Fac Med & Life Sci, LCRC, Martelarenlaan 42, B-3500 Hasselt, Belgium.; Knaepen, L (corresponding author), Jessa Hosp, Heart Ctr Hasselt, Stadsomvaart 11, B-3500 Hasselt, Belgium. Lieselotte.Knaepen@uhasselt.be |
Keywords: | Atrial fibrillation;Oral anticoagulation;Therapy adherence;Telemonitoring | Document URI: | http://hdl.handle.net/1942/41644 | ISSN: | 1861-0684 | e-ISSN: | 1861-0692 | DOI: | 10.1007/s00392-023-02261-w | ISI #: | 001038594000001 | Rights: | The Author(s) 2023. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ | Category: | A1 | Type: | Journal Contribution |
Appears in Collections: | Research publications |
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