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Assessing adherence and persistence to non-vitamin k antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation in tertiary-care referral centers in Malaysia

Introduction: Non-vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran and rivaroxaban, are now available for stroke prevention in patients with atrial fibrillation (AF) and are often clinically preferred over vitamin K antagonists (VKAs), such as warfarin. Data describing adherence...

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Main Authors: Kubas, Mohammed A., Shabaruddin, Fatiha Hana, Mazlan-Kepli, Wardati, Jagan, Nirmala, Mohamed, Sahimi, Mohamed Nazar, Nor Ilyani, Zin, Che Suraya
Format: Article
Language:English
English
Published: Wolters Kluwer Medknow Publications 2020
Subjects:
RM Therapeutics. Pharmacology
Online Access:http://irep.iium.edu.my/81695/12/81695_Assessing%20adherence%20and%20persistence%20to%20non-vitamin_baru.pdf
http://irep.iium.edu.my/81695/18/zin_kubas.pdf
http://irep.iium.edu.my/81695/
https://www.jpbsonline.org/text.asp?2020/12/6/781/300002
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spelling my.iium.irep.816952020-12-29T02:16:34Z http://irep.iium.edu.my/81695/ Assessing adherence and persistence to non-vitamin k antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation in tertiary-care referral centers in Malaysia Kubas, Mohammed A. Shabaruddin, Fatiha Hana Mazlan-Kepli, Wardati Jagan, Nirmala Mohamed, Sahimi Mohamed Nazar, Nor Ilyani Zin, Che Suraya RM Therapeutics. Pharmacology Introduction: Non-vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran and rivaroxaban, are now available for stroke prevention in patients with atrial fibrillation (AF) and are often clinically preferred over vitamin K antagonists (VKAs), such as warfarin. Data describing adherence and persistence to NOACs in real-life clinical practice in Malaysia are scarce. This study aimed to assess adherence and persistence to NOACs in patients with AF in two tertiary-care referral centers: Hospital Kuala Lumpur (HKL) and Hospital Serdang (HSDG). Materials and Methods: This was a retrospective cohort study that included all patients with AF who were treated with NOACs (dabigatran or rivaroxaban) in HKL and HSDG. Data were obtained from medical records and pharmacy databases. Adherence was assessed using proportion of days covered (PDC) over a 1-year duration. High adherence was defined as PDC ≥80%. A gap of >60 days between two consecutive refills was used to define non-persistence. Result: There were 281 patients who met the inclusion criteria, with 54.1% (n = 152) male. There were 75.1% (n = 211) patients on dabigatran and others on rivaroxaban. Only 66.9% (n = 188) of patients achieved high adherence with PDC ≥80% and 69.8% (n = 196) were persistence with >60-day gap over 12 months. Adherence and persistence were both influenced by treatment center, whereas polypharmacy only influenced adherence. Conclusion: Overall adherence and persistence to NOACs were suboptimal and varied between treatment centers, potentially due to institution-specific administrative and clinical practice differences. Clinical care and outcomes can potentially be optimized by identifying factors affecting adherence and persistence and by implementing interventions to improving them Wolters Kluwer Medknow Publications 2020 Article PeerReviewed application/pdf en http://irep.iium.edu.my/81695/12/81695_Assessing%20adherence%20and%20persistence%20to%20non-vitamin_baru.pdf application/pdf en http://irep.iium.edu.my/81695/18/zin_kubas.pdf Kubas, Mohammed A. and Shabaruddin, Fatiha Hana and Mazlan-Kepli, Wardati and Jagan, Nirmala and Mohamed, Sahimi and Mohamed Nazar, Nor Ilyani and Zin, Che Suraya (2020) Assessing adherence and persistence to non-vitamin k antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation in tertiary-care referral centers in Malaysia. Journal of Pharmacy and Bioallied Sciences, 12 (6). pp. 781-786. ISSN 0976-4879 E-ISSN 0975-7406 https://www.jpbsonline.org/text.asp?2020/12/6/781/300002 10.4103/jpbs.JPBS_381_19
institution Universiti Islam Antarabangsa Malaysia
building IIUM Library
collection Institutional Repository
continent Asia
country Malaysia
content_provider International Islamic University Malaysia
content_source IIUM Repository (IREP)
url_provider http://irep.iium.edu.my/
language English
English
topic RM Therapeutics. Pharmacology
spellingShingle RM Therapeutics. Pharmacology
Kubas, Mohammed A.
Shabaruddin, Fatiha Hana
Mazlan-Kepli, Wardati
Jagan, Nirmala
Mohamed, Sahimi
Mohamed Nazar, Nor Ilyani
Zin, Che Suraya
Assessing adherence and persistence to non-vitamin k antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation in tertiary-care referral centers in Malaysia
description Introduction: Non-vitamin K antagonist oral anticoagulants (NOACs), such as dabigatran and rivaroxaban, are now available for stroke prevention in patients with atrial fibrillation (AF) and are often clinically preferred over vitamin K antagonists (VKAs), such as warfarin. Data describing adherence and persistence to NOACs in real-life clinical practice in Malaysia are scarce. This study aimed to assess adherence and persistence to NOACs in patients with AF in two tertiary-care referral centers: Hospital Kuala Lumpur (HKL) and Hospital Serdang (HSDG). Materials and Methods: This was a retrospective cohort study that included all patients with AF who were treated with NOACs (dabigatran or rivaroxaban) in HKL and HSDG. Data were obtained from medical records and pharmacy databases. Adherence was assessed using proportion of days covered (PDC) over a 1-year duration. High adherence was defined as PDC ≥80%. A gap of >60 days between two consecutive refills was used to define non-persistence. Result: There were 281 patients who met the inclusion criteria, with 54.1% (n = 152) male. There were 75.1% (n = 211) patients on dabigatran and others on rivaroxaban. Only 66.9% (n = 188) of patients achieved high adherence with PDC ≥80% and 69.8% (n = 196) were persistence with >60-day gap over 12 months. Adherence and persistence were both influenced by treatment center, whereas polypharmacy only influenced adherence. Conclusion: Overall adherence and persistence to NOACs were suboptimal and varied between treatment centers, potentially due to institution-specific administrative and clinical practice differences. Clinical care and outcomes can potentially be optimized by identifying factors affecting adherence and persistence and by implementing interventions to improving them
format Article
author Kubas, Mohammed A.
Shabaruddin, Fatiha Hana
Mazlan-Kepli, Wardati
Jagan, Nirmala
Mohamed, Sahimi
Mohamed Nazar, Nor Ilyani
Zin, Che Suraya
author_facet Kubas, Mohammed A.
Shabaruddin, Fatiha Hana
Mazlan-Kepli, Wardati
Jagan, Nirmala
Mohamed, Sahimi
Mohamed Nazar, Nor Ilyani
Zin, Che Suraya
author_sort Kubas, Mohammed A.
title Assessing adherence and persistence to non-vitamin k antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation in tertiary-care referral centers in Malaysia
title_short Assessing adherence and persistence to non-vitamin k antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation in tertiary-care referral centers in Malaysia
title_full Assessing adherence and persistence to non-vitamin k antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation in tertiary-care referral centers in Malaysia
title_fullStr Assessing adherence and persistence to non-vitamin k antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation in tertiary-care referral centers in Malaysia
title_full_unstemmed Assessing adherence and persistence to non-vitamin k antagonist oral anticoagulants (NOACs) among patients with atrial fibrillation in tertiary-care referral centers in Malaysia
title_sort assessing adherence and persistence to non-vitamin k antagonist oral anticoagulants (noacs) among patients with atrial fibrillation in tertiary-care referral centers in malaysia
publisher Wolters Kluwer Medknow Publications
publishDate 2020
url http://irep.iium.edu.my/81695/12/81695_Assessing%20adherence%20and%20persistence%20to%20non-vitamin_baru.pdf
http://irep.iium.edu.my/81695/18/zin_kubas.pdf
http://irep.iium.edu.my/81695/
https://www.jpbsonline.org/text.asp?2020/12/6/781/300002
_version_ 1687393192226324480
score 13.211869

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