Examining Adherence to Medication in Patients With Atrial Fibrillation

Taylor, Elaina; O’Neill, Mark; Hughes, Lyndsay D.; Bennett, Peter H.; Moss‐Morris, Rona

doi:10.1097/jcn.0000000000000650

Cited by 8 publications

(16 citation statements)

References 63 publications

(81 reference statements)

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“…Patients who consumed warfarin for 3–5 years and those who experienced warfarin-related adverse events showed high medication adherence. Similar to previous studies, we found that the longer the drug administration period, the higher the patients’ knowledge about medication [ 12 , 15 ]. Additionally, patients who experienced warfarin-related adverse events showed high interest in self-management due to high medication adherence, similar to previous research.…”

Section: Discussionsupporting

confidence: 90%

“…Medication belief and self-efficacy scores were also similar to previous studies. However, as compared to those with other chronic diseases, for this study’s participants, medication adherence and depression were low [ 12 , 13 , 14 , 30 ]. In the case of patients with chronic diseases, administration of drugs has a practical effect on symptom reduction, but a direct connection between warfarin administration and symptoms is not immediately confirmed.…”

Section: Discussionmentioning

confidence: 86%

“…According to the World Health Organization, medication adherence is the degree to which a person’s behavior, represented by drug consumption, diet tracking, and lifestyle changes, agrees with a doctor or other health professional’s recommendations [ 11 ]. Non-adherence is one of the main contributors to the occurrence of adverse events, such as thromboembolism and bleeding in warfarin users; it can lead to increased morbidity, mortality, and healthcare costs [ 12 ]. Therefore, factors specific to warfarin, such as frequent PT-INR monitoring, knowledge about warfarin, recognition of signs of adverse events, and patient behavior towards warfarin therapy, should be considered while assessing medication adherence to warfarin therapy [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Patients with mechanical valves have to be aware of the therapeutic effects of oral anticoagulants, check for symptoms of adverse events, and pay attention to their medication’s interaction with other drugs and foods. Due to the stress from managing these medication-related factors, they might experience symptoms of depression [ 12 ]. Depression decreases patients’ interest in the disease or treatment, negatively affects drug use, and leads to a lack of social support and treatment pessimism [ 17 ].…”

Section: Introductionmentioning

confidence: 99%

“…Treatment beliefs about medication include necessity beliefs, which are related to the perceived need for treatment, and concern beliefs, which are related to side effects, dependence, and tolerance to medication [ 19 ]. Medication belief during treatment is a stronger predictor of adherence than other clinical or demographic variables [ 12 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Factors Affecting Medication Adherence in Patients with Mechanical Heart Valves Taking Warfarin: The Role of Knowledge on Warfarin, Medication Belief, Depression, and Self-Efficacy

Park

Jang

2021

IJERPH

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Non-adherence is highlighted as one of the main contributors to the occurrence of adverse events and negative clinical outcomes in patients treated with warfarin. The aim was to examine knowledge on warfarin, medication belief, depression, and self-efficacy as factors influencing medication adherence for anticoagulation control. This was a cross-sectional study. The participants in this study were patients who visited an outpatient clinic of cardiovascular surgery to administer anticoagulants after mechanical valve replacement surgery at a tertiary hospital in Seoul. Responses of 154 participants on questionnaires were analyzed from 10 September to 26 December 2020. Multiple regression analyses were performed to assess the factors influencing medication adherence among the patients with anticoagulation control. Factors influencing medication adherence were consuming warfarin for 3 to 5 years, awareness of target prothrombin time international normalized ratio, knowledge of warfarin, and depression. Medication beliefs and self-efficacy had no significant influence on medication adherence. The most important factors associated with medication adherence in patients with mechanical heart valves were knowledge about warfarin and depression. In the control of oral anticoagulants that require continuous management, education and providing accurate guidance is more important than personal preferences. Clinical nurses should facilitate educational programs tailored to the characteristics of the patient, including their purpose and method of taking warfarin, specific diets, their knowledge on warfarin’s interaction with other drugs, symptoms of adverse events, and self-management. In addition, healthcare providers should check whether warfarin therapy is being controlled by evaluating medication adherence and depression levels among patients.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Factors Affecting Medication Adherence in Patients with Mechanical Heart Valves Taking Warfarin: The Role of Knowledge on Warfarin, Medication Belief, Depression, and Self-Efficacy

Park

Jang

2021

IJERPH

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Long-term adherence to direct acting oral anticoagulants and the influence of health beliefs after switching from vitamin-K antagonists: Findings from the Switching Study

Bartoli-Abdou

Patel

Vadher

et al. 2021

Thrombosis Research

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Association of Depression and Adherence to Oral Anticoagulation in Patients With Atrial Fibrillation

Lapa,

Swabe,

Magnani

2023

JAHA

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Background Adherence to oral anticoagulation is essential for stroke prevention in atrial fibrillation (AF). Depression has been associated with decreased adherence to medications in multiple disease states and in AF is further associated with increased risk of stroke. We hypothesized that individuals with depression and AF have decreased adherence to anticoagulation than those without depression. Methods and Results We used administrative claims data to identify individuals with AF initiating anticoagulation with direct‐acting oral anticoagulants (DOACs) or warfarin between 2013 and 2019. We quantified adherence using proportion of days covered, categorized as limited (proportion of days covered, <80%), adequate (proportion of days covered, ≥80% to <90%), or optimal (proportion of days covered, ≥90%). We related depression to 12‐month adherence to anticoagulation in logistic regression models, adjusting for demographics, medical and psychiatric comorbidities, household income, educational attainment, and insurance type. As a secondary analysis, we determined the association of depression to adherence for each DOAC agent. We identified 101 041 individuals (aged 74.5±8.9 years; 50.6% women; 29.5% race or ethnicity other than White, including Asian or Black race and Hispanic ethnicity) who initiated either DOACs or warfarin. The odds of adequate adherence to DOACs was 11% (95% CI, 0.85–0.93), and the odds of optimal adherence was 12% (95% CI, 0.83–0.91) less in individuals with depression than those without. Depression was not associated with adherence to warfarin. Conclusions We identified an association between depression and decreased adherence to DOACs but not warfarin in individuals with AF. Recognizing depression in AF may guide interventions to improve anticoagulation adherence and reduce stroke risk.

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Examining Adherence to Medication in Patients With Atrial Fibrillation

Cited by 8 publications

References 63 publications

Factors Affecting Medication Adherence in Patients with Mechanical Heart Valves Taking Warfarin: The Role of Knowledge on Warfarin, Medication Belief, Depression, and Self-Efficacy

Factors Affecting Medication Adherence in Patients with Mechanical Heart Valves Taking Warfarin: The Role of Knowledge on Warfarin, Medication Belief, Depression, and Self-Efficacy

Long-term adherence to direct acting oral anticoagulants and the influence of health beliefs after switching from vitamin-K antagonists: Findings from the Switching Study

Association of Depression and Adherence to Oral Anticoagulation in Patients With Atrial Fibrillation

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