Key result
A novel predictive scale based on risk factors including low income, prior stroke, and warfarin use identified low adherence to anticoagulant therapy with 90.2% sensitivity and 98.4% specificity.
Why the study?
The study aimed to identify risk factors for low adherence to anticoagulant therapy and develop a predictive scale in patients with AF.
Can a newly developed predictive scale accurately identify low adherence to anticoagulant therapy in patients with atrial fibrillation?
Observational (n=199)
Can a newly developed predictive scale accurately identify low adherence to anticoagulant therapy in patients with atrial fibrillation?
A newly developed predictive scale based on clinical and socioeconomic factors can accurately identify atrial fibrillation patients at high risk for non-adherence to oral anticoagulation.
Predictive adherence score linked to outcomes in high-risk AF; hypothesis-generating and requires validation before clinical adoption.
Aim. To identify risk factors for low adherence and develop a scale for its prediction. To evaluate the association of the predictive score with actual low adherence according to the 8-item Morisky Medication Adherence Scale, self-drug withdrawal, and adverse outcomes in patients with atrial fibrillation (AF). Material and methods. The study included patients with AF and a high risk of thromboembolic events according to the CHA2DS2-VASc scale, who were hospitalized from January 2011 to December 2017. Potential risk factors for non-adherence, selected from the literature, were tested in a multivariate regression analysis followed by the development of an adherence prediction scale. The association of predicted low adherence with actual adherence was assessed. Results. The study included 199 patients. The analysis identified following predictors of low adherence: low income, history of bleeding, prior stroke, 4 positive responses to the adherence questionnaire, warfarin. Based on these predictors, a scale for predicting adherence was developed, while a threshold value of 3 points was identified (sensitivity, 90,2%, specificity, 98,4%). A significant association of low predicted adherence on the developed scale with actual adherence and adverse outcomes was demonstrated. Conclusion. We have developed a scale for predicting adherence to anticoagulant therapy, and also determined its threshold value. In case of a high risk of low adherence, clinicians should try to increase adherence in order to prevent complications.
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Певзнер et al. (2023) conducted an observational in atrial fibrillation (n=199). Predictive scale for low adherence was evaluated on Low adherence to anticoagulant therapy. A novel predictive scale based on risk factors including low income, prior stroke, and warfarin use identified low adherence to anticoagulant therapy with 90.2% sensitivity and 98.4% specificity.
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