Direct oral anticoagulants: patient reported adherence and minor bleedings

Hayat, Amina; Själander, Anders; Wallvik, Jonas

doi:10.1007/s11239-023-02797-8

Cited by 2 publications

(1 citation statement)

References 24 publications

(26 reference statements)

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“…The findings showed that rivaroxaban was the most used NOAC drug, followed by apixaban and dabigatran, while edoxaban was the least used. Hayat et al ( 29 ) conducted a real-world study of 668 patients with AF which showed that rivaroxaban had significantly better compliance and lower bleeding risk than dabigatran and Apoxaban. Therefore, Rivaroxaban has become the most popular new oral anticoagulant drug in clinic due to its once-daily dosing schedule and better anticoagulant effect.…”

Section: Discussionmentioning

confidence: 99%

Post-TAVR patients with atrial fibrillation: are NOACs better than VKAs?—A meta-analysis

Wang,

Sang,

Jian

et al. 2023

Front. Cardiovasc. Med.

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ObjectiveThis study aimed to compare the efficacy of novel oral anticoagulants (NOACs) with traditional anticoagulants vitamin K antagonists (VKAs) in patients with atrial fibrillation (AF) post transcatheter aortic valve replacement (TAVR).MethodsStudies comparing the usage of NOACs and VKAs in AF patients with oral anticoagulant indication post-TAVR were retrieved from PubMed, EMBASE, Medline, and Cochrane databases from their building-up to Jan. 2023. The literature was screened in line of inclusion and exclusion criteria. Risk ratio (RR) or odds ratio (OR),95% confidence interval (CI) and number needed to treat (NNT) were calculated for four main indexes that composite endpoints composed mainly of any clinically relevant risk events, stroke, major bleeding, and all-cause mortality. Subsequently, a meta-analysis was performed using the RevMan5.3 and Stata 16.0 software.ResultsIn the aggregate of thirteen studies, contained 30388 post-TAVR patients with AF, were included in this meta-analysis. Our results indicated that there was no significant difference in stroke between the NOACs group and the VKAs group, and the NOACs group had a numerically but non-significantly higher number of composite endpoint events compared with the other group. Nevertheless, the incidence of major bleeding [11.29% vs. 13.89%, RR 0.82, 95%CI (0.77,0.88), P < 0.00001, I² = 69%, NNT = 38] and all-cause mortality [14.18% vs. 17.61%, RR 0.83, 95%CI (0.79,0.88), p < 0.00001, I² = 82%, NNT = 29] were significantly lower in the NOACs group than another group.ConclusionTaken together, our data indicated that the usage of NOACs reduced the incidence of major bleeding and all-cause mortality compared to VKAs in post-TAVR patients with AF.

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Section: Discussionmentioning

confidence: 99%

Post-TAVR patients with atrial fibrillation: are NOACs better than VKAs?—A meta-analysis

Wang,

Sang,

Jian

et al. 2023

Front. Cardiovasc. Med.

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Medication Adherence to Direct Oral Anticoagulants: Extent and Impact of Side Effects

van de Steeg,

Esselink,

de Wit

et al. 2024

PPA

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Purpose Arterial and venous thromboembolism are a leading cause of mortality. Direct oral anticoagulants (DOACs) are highly effective in both stroke prevention and prevention of venous thrombotic events. Medication adherence is a prerequisite for optimal protection against thromboembolic complications. Recent studies have shown that good adherence cannot be taken for granted by DOACs. In this cross-sectional study adherence among DOAC users was investigated and associations between beliefs about medication, perceived side effects and adherence were explored. Patients and Methods We included 100 randomly selected adult DOAC users visiting one of the two participating Dutch community pharmacies in the summer of 2020. The self-reported adherence (primary outcome) was assessed with the Medication Adherence Rating Scale-5 (MARS-5) using three different cut-off scores. Beliefs about DOACs were assessed with the Beliefs about Medicine Questionnaire Specific (BMQ-S), while side effects and side effect burden were assessed with a self-developed questionnaire based on the Lareb Intensive Monitoring (LIM) system. Results Of the participants, 9% reported non-adherence on the primary MARS-5 cut-off score <24. For the MARS-5 scores <23 and <25 non-adherence percentages of, respectively, 3 and 33% were calculated. Associations were found between adherence and both side effects and side effect burden, regardless of the MARS-5 cut-off score. Bruising and minor bleeds were the most reported side effects (both 20%). For all patients, the necessity beliefs outweighed the concern beliefs. No associations were found between adherence and either gender, indication, DOAC or dosage. Conclusion This study confirms that adherence in patients on DOACs cannot be taken for granted. High necessity beliefs do not guarantee good adherence, as side effects impair adherence even in patients having high necessity beliefs. Therefore, we recommend that both physicians and pharmacists evaluate both adherence and side effects with these patients on a regular base.

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Direct oral anticoagulants: patient reported adherence and minor bleedings

Cited by 2 publications

References 24 publications

Post-TAVR patients with atrial fibrillation: are NOACs better than VKAs?—A meta-analysis

Post-TAVR patients with atrial fibrillation: are NOACs better than VKAs?—A meta-analysis

Medication Adherence to Direct Oral Anticoagulants: Extent and Impact of Side Effects

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