Adherence to Direct Oral Anticoagulants in Patients With Non-Valvular Atrial Fibrillation : A Cross-National Comparison in Six European Countries (2008-2015)
Sabaté, Mònica (Hospital Universitari Vall d'Hebron)
Vidal Guitart, Xavier (Hospital Universitari Vall d'Hebron)
Ballarín, Elena (Hospital Universitari Vall d'Hebron)
Rottenkolber, Mònica (Klinikum der Universität München)
Schmiedl, Sven (Helios University Hospital Wuppertal)
Grave, Birgit (AOK NORDWEST)
Huerta, C. (Agència Espanyola de Medicaments i Productes Sanitaris (AEMPS))
Martin-Merino, E. (Agència Espanyola de Medicaments i Productes Sanitaris (AEMPS))
Montero, Dolores (Agència Espanyola de Medicaments i Productes Sanitaris (AEMPS))
Leon-Muñoz, L. M. (Agència Espanyola de Medicaments i Productes Sanitaris (AEMPS))
Gasse, Christiane (Aarhus University)
Moore, Nicholas (Université de Bordeaux)
Droz, Cécile (Université de Bordeaux)
Lassalle, Régis (Université de Bordeaux)
Aakjær, Mia (University of Copenhagen)
Andersen, Morten (University of Copenhagen)
De Bruin, Marie Louise (University of Copenhagen)
Souverein, Patrick (Utrecht Institute for Pharmaceutical Sciences)
Klungel, O. H. (University Medical Center Utrecht)
Gardarsdottir, Helga (University of Iceland)
Ibáñez, Luisa (Hospital Universitari Vall d'Hebron)
Universitat Autònoma de Barcelona [...] Mostra tots els 22 autors

Data:	2021
Resum:	To describe and compare the adherence to different direct oral anticoagulants (DOACs) in eight European databases representing six countries. Longitudinal drug utilization study of new users (≥18 years) of DOACs (dabigatran, rivaroxaban, apixaban) with a diagnosis of non-valvular atrial fibrillation (2008-2015). Adherence was examined by estimating persistence, switching, and discontinuation rates at 12 months. Primary non-adherence was estimated in BIFAP and SIDIAP databases. The highest persistence rate was seen for apixaban in the CPRD database (81%) and the lowest for dabigatran in the Mondriaan database (22%). The switching rate for all DOACs ranged from 2. 4 to 13. 1% (Mondriaan and EGB databases, respectively). Dabigatran had the highest switching rate from 5. 0 to 20. 0% (Mondriaan and EGB databases, respectively). The discontinuation rate for all DOACs ranged from 16. 0 to 63. 9% (CPRD and Bavarian CD databases, respectively). Dabigatran had the highest rate of discontinuers, except in the Bavarian CD and AOK NORDWEST databases, ranging from 23. 2 to 64. 6% (CPRD and Mondriaan databases, respectively). Combined primary non-adherence for examined DOACs was 11. 1% in BIFAP and 14. 0% in SIDIAP. There were differences in population coverage and in the type of drug data source among the databases. Despite the differences in the characteristics of the databases and in demographic and baseline characteristics of the included population that could explain some of the observed discrepancies, we can observe a similar pattern throughout the databases. Apixaban was the DOAC with the highest persistence. Dabigatran had the highest proportion of discontinuers and switchers at 12 months in most databases (EMA/2015/27/PH).
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Adherence ; Anticoagulants ; Cardiovascular ; Drug utilization ; Europe ; Non valvular atrial fibrillation ; Persistence ; Pharmacoepidemiology
Publicat a:	Frontiers in Pharmacology, Vol. 12 (november 2021) , ISSN 1663-9812

DOI: 10.3389/fphar.2021.682890
PMID: 34803665

14 p, 1.3 MB

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