OBJECTIVES

: Treatment adherence is of utmost importance for providing effective treatment with oral anticoagulation treatment in atrial fibrillation (AF) patients. However, there is still a lack of knowledge why patients do not adhere to treatment, especially which role patients’ satisfaction with their treatment plays in this context.

METHODS

: A cross-sectional survey was conducted in France, Germany and UK including AF patients currently receiving a non–vitamin K antagonist oral anticoagulation (NOAC).

Adherence to treatment was assessed using the Morisky Medication Adherence Scale (©MMAS-8, ©2006 Donald E. Morisky). Treatment satisfaction of patients was measured based on a single-item measure (scale ranging from 1 ‘not satisfied’ to 10 ‘extremely satisfied’). Additionally, it was assessed whether a patient would prefer a different dosing regimen, compared to that of the current NOAC therapy (either once or twice daily).

The effect of treatment satisfaction/preference on the probability of low adherence was estimated by a logistic regression. In this model further covariates were considered (age/gender/country/ comorbidity level/number of concomitant medications/type of treating physician/treatment duration/NOAC pre-treatment).

RESULTS

: The mean MMAS-score was 7.2 (SD:1.1). In total, 10.5%/38.9% of the patients reported low/medium adherence to their anticoagulation treatment. The mean satisfaction score was 8.64 (SD:1.6). While 47.8% of the patients treated with a BID NOAC would prefer another dosing regimen only 1.3% of patients on an OD NOAC do so.

In our regression model, a lower treatment satisfaction was associated with a higher risk of low adherence (HR:1.325;p<0.001). Furthermore, patients who strongly preferred another dosing regimen showed a higher probability of low adherence (HR:3.500;p<0.001).

CONCLUSIONS

: Prescribing OAC treatments that AF patients prefer can help to increase long-term adherence with the prescribed treatment.

Use-of-the-MMAS-is-protected-by-US-and-International-copyright-laws.-Permission-for-use-is-required.-A-license-agreement-is-available-from:-Donald-E.-Morisky,-MMAS-Research-(MORISKY),-294-Lindura-Court,-Las-Vegas,-NV-89135-1415;-dmorisky@gmail.com