How important it is for therapy adherence to be once a day?

New oral anticoagulants (NOACs) or non-vitamin K antagonists (VKAs) do not possess the numerous negative properties of VKAs in the therapy of atrial fibrillation patients. NOACs have a more rapid onset of action, are less dependent on interactions, food intake, age and body weight, and there are fewer gene polymorphisms. The large Phase III trials have shown that all NOACs are not inferior to VKA therapy. Nevertheless, these results are certainly based on the adherence and persistence to NOAC therapy. A once-a-day strategy has been shown to increase the adherence to therapy. Therefore, this review provides an overview over adherence to NOAC therapy and tries to assess the impact of once-a-day treatment regiments on treatment adherence in anticoagulated patients with atrial fibrillation.