Arrhythmias & electrophysiology
Assessing methods to ascertain persistence and adherence of oral anticoagulants in patients with atrial fibrillation
Authors' conclusion
We found that the estimated persistence rates are sensitive to the choice of ascertainment methods.
Study context
- Population
- Patients with atrial fibrillation (AF) initiating OAC, Medicare claims 01/01/2013–12/31/2019
- Participants
- 1,398,692 OAC initiators
- Exposure
- Persistence/adherence ascertainment methods for OAC
- Outcome
- OAC persistence by treatment-anniversary (with vs without 15-day buffer) and dispensing-gap (5-60 days) methods
- Follow-up
- 180 days and 1 year
Methodological detailsMedicare claims data, incident user cohort
- Medicare claims data
- Incident user cohort
Main finding
As reported in the abstract
Persistence by ascertainment method
Treatment-anniversary persistence at 180 days, warfarin or DOACs
51.2% to 65.4%
Treatment-anniversary persistence at 1 year, warfarin or DOACs
43.4% to 60.7%
Increase in treatment-anniversary persistence with 15-day buffer
6.5% to 10.5%
Increase in persistence when allowable gap increased from 5 to 60 days, all oral anticoagulants (OACs)
36.3% to 42.4%
Observational data: associations, not effects.
Further findings
| Outcome | Values |
|---|---|
| PDC adherence · 365 days · Apixaban highest PDC | Apixaban 74%-75% |
- Proportion of days covered (PDC) adherence — PDC in other OACs
- 60%-69%
Original publication
Assessing methods to ascertain persistence and adherence of oral anticoagulants in patients with atrial fibrillation. Am Heart J. Published 18 September 2024. doi:10.
Summarised from the published abstract; every number is checked against it