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Emren S, Zoghi M, Karagöz U, Inci S, Açiksari G, Bekar L, Emren Z, Ergene O. Assessment of the compatibility of the real-world nonvalvular atrial fibrillation patients in Turkey with the study population of Phase 3 novel oral anticoagulant trials: An auxiliary study of NOAC-TR. Int J Cardiovasc Acad 2020. [DOI: 10.4103/ijca.ijca_39_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Emren SV, Şenöz O, Bilgin M, Beton O, Aslan A, Taşkin U, Açiksari G, Asarcikli LD, Çakir H, Bekar L, Bolat İ, Yayla Ç, Çelebi B, Dalgiç O, Çelik O, Şafak Ö, Akyel S, Güngör H, Düzel B, Zoghi M. Drug Adherence in Patients With Nonvalvular Atrial Fibrillation Taking Non-Vitamin K Antagonist Oral Anticoagulants in Turkey: NOAC-TR. Clin Appl Thromb Hemost 2017; 24:525-531. [PMID: 28301907 DOI: 10.1177/1076029617693940] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Adherence to non-vitamin K antagonist oral anticoagulants (NOACs) is an important factor for ensuring efficacy and safety in nonvalvular atrial fibrillation (NVAF). There are controversial results regarding NOAC adherence in real-world data and there are no data about NOAC adherence in Turkish population. This study investigated the NOAC adherence based on self-report, factors affecting nonadherence, and the relation of the adherence level with efficacy and safety outcomes. This multicenter cross-sectional study included 2738 patients (59% female) using NOAC (dabigatran, apixaban, and rivaroxaban) due to NVAF for more than 3 months with >30 days of supply between September 1, 2015, and February 28, 2016. To measure the adherence level, an 8-item Morisky Medication Adherence Scale was used. The mean age of the patients was 70 ± 10 years. Of the 2738 patients, 44% were receiving dabigatran, 38% rivaroxaban, and 18% apixaban. A total of 630 (23%) patients had high medication adherence, 712 (26%) moderate adherence, and 1396 (51%) low adherence. Nonadherence had related to stroke (5.6% vs 2.5%, P < .001) and minor (21.2% vs 11.1%, P < .001) and major (6.1% vs 3.7%, P = .004) bleeding rates. The adherence to NOAC was found to be quite low in Turkey. Nonadherence is associated with bleeding and thromboembolic cardiovascular events. Age, taking NOAC twice a day, and the additional noncardiac diseases, depression, and dementia were the independent factors affecting poor medication adherence.
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Affiliation(s)
- Sadık Volkan Emren
- 1 Department of Cardiology, Afyonkarahisar State Hospital, Afyonkarahisar, Turkey
| | - Oktay Şenöz
- 2 Department of Cardiology, Artvin State Hospital, Artvin, Turkey
| | - Murat Bilgin
- 3 Department of Cardiology, Ankara Dışkapı Research and Education Hospital, Ankara, Turkey
| | - Osman Beton
- 4 Department of Cardiology, Sivas Cumhuriyet University, Sivas, Turkey
| | - Abdullah Aslan
- 5 Department of Cardiology, Dokuz Eylül University, Izmir, Turkey
| | - Uğur Taşkin
- 6 Department of Cardiology, Akşehir State Hospital, Konya, Turkey
| | - Gönül Açiksari
- 7 Department of Cardiology, Istanbul İstinye State Hospital, Istanbul, Turkey
| | - Lale Dinç Asarcikli
- 3 Department of Cardiology, Ankara Dışkapı Research and Education Hospital, Ankara, Turkey
| | - Hakan Çakir
- 8 Department of Cardiology, Darıca Farabi State Hospital, Kocaeli, Turkey
| | - Lütfü Bekar
- 9 Department of Cardiology, Hitit University, Çorum, Turkey
| | - İsmail Bolat
- 10 Department of Cardiology, Fethiye State Hospital, Muğla, Turkey
| | - Çağrı Yayla
- 11 Department of Cardiology, Ankara Yüksek İhtisas Research and Education Hospital, Ankara, Turkey
| | - Barış Çelebi
- 12 Department of Cardiology, Silifke State Hospital, Mersin, Turkey
| | - Onur Dalgiç
- 13 Department of Cardiology, Karşıyaka State Hospital, İzmir, Turkey
| | - Oğuzhan Çelik
- 14 Department of Cardiology, School of Medicine, Hitit University, Çorum, Turkey
| | - Özgen Şafak
- 15 Department of Cardiology, Burdur State Hospital, Burdur, Turkey
| | - Serdar Akyel
- 16 Department of Cardiology, Münif İslamoğlu State Hospital, Kastamonu, Turkey
| | - Hasan Güngör
- 17 Department of Cardiology, Aydın University School of Medicine, Aydın, Turkey
| | - Barış Düzel
- 18 Department of Cardiology, Mersin State Hospital, Mersin, Turkey
| | - Mehdi Zoghi
- 19 Department of Cardiology, Ege University, Izmir, Turkey
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