Type and doses of oral anticoagulants and adherence to anticoagulant treatment in elderly patients with atrial fibrillation: the ESPARTA study

J Comp Eff Res. 2018 Mar;7(3):223-232. doi: 10.2217/cer-2017-0034. Epub 2018 Feb 21.

Abstract

Aim: To analyze the use of oral anticoagulants in elderly patients with atrial fibrillation in clinical practice.

Patients & methods: Cross-sectional and multicenter study performed in atrial fibrillation patients ≥75 years treated with oral anticoagulants ≥3 months.

Results: 837 patients (83.0 ± 5.0 years; CHA2DS2-VASc 5.0 ± 1.4; HAS-BLED 2.1 ± 0.9; 70.8% vitamin K antagonists; 29.2% direct oral anticoagulants [DOACs]) were included. Poor adherence was observed in 27.9% of patients. Higher scores in the Pfeiffer's test and FRAIL scale were associated with poorer adherence. Among patients treated with DOACs, 62.3% received the lower doses. Having high CHADS2 score and being older were associated with the use of low doses.

Conclusion: 28% of patients had a poor adherence to anticoagulant treatment. 62% of patients were treated with the lower doses of DOACs.

Keywords: adherence; atrial fibrillation; direct oral anticoagulants; dosage; elderly; vitamin K antagonists.

Publication types

  • Multicenter Study
  • Observational Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Administration, Oral
  • Aged, 80 and over
  • Anticoagulants / administration & dosage*
  • Atrial Fibrillation / drug therapy*
  • Cross-Sectional Studies
  • Female
  • Hemorrhage / chemically induced
  • Humans
  • Male
  • Medication Adherence
  • Polypharmacy
  • Stroke / prevention & control

Substances

  • Anticoagulants