Cargando…

Adherence and Persistence with Once-Daily vs Twice-Daily Direct Oral Anticoagulants Among Patients with Atrial Fibrillation: Real-World Analyses from the Netherlands, Italy and Germany

BACKGROUND: Direct oral anticoagulants are available for patients with atrial fibrillation. OBJECTIVE: This study compared adherence and persistence of once-daily (QD) vs twice-daily (BID) direct oral anticoagulants in patients with atrial fibrillation. METHODS: A cohort study was conducted in three...

Descripción completa

Detalles Bibliográficos
Autores principales: Smits, Elisabeth, Andreotti, Felicita, Houben, Eline, Crijns, Harry J. G. M., Haas, Sylvia, Spentzouris, George, Schink, Tania, Gini, Rosa, Bartolini, Claudia, Penning-van Beest, Fernie, Herings, Ron
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer International Publishing 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9114199/
https://www.ncbi.nlm.nih.gov/pubmed/34993898
http://dx.doi.org/10.1007/s40801-021-00289-w
_version_ 1784709727583731712
author Smits, Elisabeth
Andreotti, Felicita
Houben, Eline
Crijns, Harry J. G. M.
Haas, Sylvia
Spentzouris, George
Schink, Tania
Gini, Rosa
Bartolini, Claudia
Penning-van Beest, Fernie
Herings, Ron
author_facet Smits, Elisabeth
Andreotti, Felicita
Houben, Eline
Crijns, Harry J. G. M.
Haas, Sylvia
Spentzouris, George
Schink, Tania
Gini, Rosa
Bartolini, Claudia
Penning-van Beest, Fernie
Herings, Ron
author_sort Smits, Elisabeth
collection PubMed
description BACKGROUND: Direct oral anticoagulants are available for patients with atrial fibrillation. OBJECTIVE: This study compared adherence and persistence of once-daily (QD) vs twice-daily (BID) direct oral anticoagulants in patients with atrial fibrillation. METHODS: A cohort study was conducted in three databases in the Netherlands, Italy and Germany. Patients with AF starting direct oral anticoagulants after drug approval date were included. The index date was the date of first dispensing. Study patients were restricted to those aged ≥ 18 years, ≥ 1 year database history and ≥ 1 year follow-up. Adherence to treatment was defined as the proportion of days covered ≥ 80% between the index date and the date of last dispensing of the index regimen (i.e. exposure period). The proportion of days covered was also determined during the 12-month follow-up. Persistence was defined as continuous use from index to treatment discontinuation. RESULTS: In the Netherlands, Italy and Germany, respectively, 6068, 32,260 and 167,445 patients were included. The mean age of the patients was 70, 77 and 74 years, and 31%, 40% and 61% were QD users, all respectively. Among QD/BID users, 93/90%, 88/86% and 77/58%, respectively were adherent during the exposure period. Persistence rates at 1 year in QD/BID users were 60/59%, 13/14% and 46/31%, respectively. CONCLUSIONS: Adherence to treatment was high. In Germany, adherence was markedly higher in QD users compared with BID users. In Italy and the Netherlands, these differences were marginal. Persistence was low in all countries, but discontinuation was temporary. Only in Germany, persistence was markedly lower in BID users vs QD users. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40801-021-00289-w.
format Online
Article
Text
id pubmed-9114199
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Springer International Publishing
record_format MEDLINE/PubMed
spelling pubmed-91141992022-05-19 Adherence and Persistence with Once-Daily vs Twice-Daily Direct Oral Anticoagulants Among Patients with Atrial Fibrillation: Real-World Analyses from the Netherlands, Italy and Germany Smits, Elisabeth Andreotti, Felicita Houben, Eline Crijns, Harry J. G. M. Haas, Sylvia Spentzouris, George Schink, Tania Gini, Rosa Bartolini, Claudia Penning-van Beest, Fernie Herings, Ron Drugs Real World Outcomes Original Research Article BACKGROUND: Direct oral anticoagulants are available for patients with atrial fibrillation. OBJECTIVE: This study compared adherence and persistence of once-daily (QD) vs twice-daily (BID) direct oral anticoagulants in patients with atrial fibrillation. METHODS: A cohort study was conducted in three databases in the Netherlands, Italy and Germany. Patients with AF starting direct oral anticoagulants after drug approval date were included. The index date was the date of first dispensing. Study patients were restricted to those aged ≥ 18 years, ≥ 1 year database history and ≥ 1 year follow-up. Adherence to treatment was defined as the proportion of days covered ≥ 80% between the index date and the date of last dispensing of the index regimen (i.e. exposure period). The proportion of days covered was also determined during the 12-month follow-up. Persistence was defined as continuous use from index to treatment discontinuation. RESULTS: In the Netherlands, Italy and Germany, respectively, 6068, 32,260 and 167,445 patients were included. The mean age of the patients was 70, 77 and 74 years, and 31%, 40% and 61% were QD users, all respectively. Among QD/BID users, 93/90%, 88/86% and 77/58%, respectively were adherent during the exposure period. Persistence rates at 1 year in QD/BID users were 60/59%, 13/14% and 46/31%, respectively. CONCLUSIONS: Adherence to treatment was high. In Germany, adherence was markedly higher in QD users compared with BID users. In Italy and the Netherlands, these differences were marginal. Persistence was low in all countries, but discontinuation was temporary. Only in Germany, persistence was markedly lower in BID users vs QD users. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40801-021-00289-w. Springer International Publishing 2022-01-06 /pmc/articles/PMC9114199/ /pubmed/34993898 http://dx.doi.org/10.1007/s40801-021-00289-w Text en © The Author(s) 2022 https://creativecommons.org/licenses/by-nc/4.0/Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial 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-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Original Research Article
Smits, Elisabeth
Andreotti, Felicita
Houben, Eline
Crijns, Harry J. G. M.
Haas, Sylvia
Spentzouris, George
Schink, Tania
Gini, Rosa
Bartolini, Claudia
Penning-van Beest, Fernie
Herings, Ron
Adherence and Persistence with Once-Daily vs Twice-Daily Direct Oral Anticoagulants Among Patients with Atrial Fibrillation: Real-World Analyses from the Netherlands, Italy and Germany
title Adherence and Persistence with Once-Daily vs Twice-Daily Direct Oral Anticoagulants Among Patients with Atrial Fibrillation: Real-World Analyses from the Netherlands, Italy and Germany
title_full Adherence and Persistence with Once-Daily vs Twice-Daily Direct Oral Anticoagulants Among Patients with Atrial Fibrillation: Real-World Analyses from the Netherlands, Italy and Germany
title_fullStr Adherence and Persistence with Once-Daily vs Twice-Daily Direct Oral Anticoagulants Among Patients with Atrial Fibrillation: Real-World Analyses from the Netherlands, Italy and Germany
title_full_unstemmed Adherence and Persistence with Once-Daily vs Twice-Daily Direct Oral Anticoagulants Among Patients with Atrial Fibrillation: Real-World Analyses from the Netherlands, Italy and Germany
title_short Adherence and Persistence with Once-Daily vs Twice-Daily Direct Oral Anticoagulants Among Patients with Atrial Fibrillation: Real-World Analyses from the Netherlands, Italy and Germany
title_sort adherence and persistence with once-daily vs twice-daily direct oral anticoagulants among patients with atrial fibrillation: real-world analyses from the netherlands, italy and germany
topic Original Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9114199/
https://www.ncbi.nlm.nih.gov/pubmed/34993898
http://dx.doi.org/10.1007/s40801-021-00289-w
work_keys_str_mv AT smitselisabeth adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany
AT andreottifelicita adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany
AT houbeneline adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany
AT crijnsharryjgm adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany
AT haassylvia adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany
AT spentzourisgeorge adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany
AT schinktania adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany
AT ginirosa adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany
AT bartoliniclaudia adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany
AT penningvanbeestfernie adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany
AT heringsron adherenceandpersistencewithoncedailyvstwicedailydirectoralanticoagulantsamongpatientswithatrialfibrillationrealworldanalysesfromthenetherlandsitalyandgermany