Abstract
Aims Effective anticoagulation in patients undergoing electrical cardioversion (ECV) for symptomatic atrial fibrillation is important to prevent adverse events. High medication adherence is a requirement. In patients with newly diagnosed atrial fibrillation (n = 169) who were intended to undergo ECV, the aim of this study was to measure self-reported short- and long-term adherence, evaluate whether dabigatran plasma concentrations reflect adherence, measure treatment satisfaction and assess whether adherence and treatment satisfaction are correlated. Methods and results Plasma concentrations (liquid-chromatography tandem mass spectrometry), the 8-point Morisky Medication Adherence Scale (MMAS-8) and the Anti-Clot Treatment Scale (ACTS) were measured after 3 weeks and 7 weeks of treatment. Combined mean peak (1-3 h after intake) and trough (10-16 h after intake) plasma concentrations were 175 (SD 109) ng/mL and 75 (SD 45) ng/mL, respectively. There was no relationship between short-term adherence (last 3 days) or long-term adherence (last 3-4 weeks) and plasma concentrations, unless the last intake was more than 48 h ago. After 7 weeks high, moderate, and low adherence, according to the MMAS-8, was seen in 74%, 21%, and 5% of patients, respectively. Treatment satisfaction was high (median ACTS score 68.5, range 46-75 points). Treatment satisfaction and adherence were not correlated. Conclusion The percentage of patients in the high adherence group (74%) was lower than expected, which is a matter of concern. Dabigatran plasma concentrations could not detect short- or long-term non-adherence, unless the drug was last taken more than 48 h ago. Treatment satisfaction did not correlate with adherence.
| Original language | English |
|---|---|
| Pages (from-to) | 91-99 |
| Number of pages | 9 |
| Journal | European Heart Journal - Cardiovascular Pharmacotherapy |
| Volume | 5 |
| Issue number | 2 |
| DOIs | |
| Publication status | Published - 1 Apr 2019 |
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Keywords
- Antidepressive agents
- Atrial fibrillation
- Dabigatran
- Drug interactions
- Mass spectrometry
- Medication adherence
- Second generation
- Prospective Studies
- Humans
- Self Report
- Electric Countershock
- Male
- Treatment Outcome
- Patient Satisfaction
- Drug Monitoring/methods
- Tandem Mass Spectrometry
- Medication Adherence
- Time Factors
- Dabigatran/administration & dosage
- Chromatography, Liquid
- Female
- Aged
- Antithrombins/administration & dosage
- Atrial Fibrillation/diagnosis
Cite this
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Adherence to dabigatran etexilate in atrial fibrillation patients intended to undergo electrical cardioversion. / Comuth, Willemijn J. (Corresponding author); de Maat, Moniek P.M.; van de Kerkhof, Daan; Malczynski, Jerzy; Husted, Steen; Kristensen, Steen D.; Münster, Anna Marie B.
In: European Heart Journal - Cardiovascular Pharmacotherapy, Vol. 5, No. 2, 01.04.2019, p. 91-99.Research output: Contribution to journal › Article › Academic › peer-review
TY - JOUR
T1 - Adherence to dabigatran etexilate in atrial fibrillation patients intended to undergo electrical cardioversion
AU - Comuth, Willemijn J.
AU - de Maat, Moniek P.M.
AU - van de Kerkhof, Daan
AU - Malczynski, Jerzy
AU - Husted, Steen
AU - Kristensen, Steen D.
AU - Münster, Anna Marie B.
PY - 2019/4/1
Y1 - 2019/4/1
N2 - Aims Effective anticoagulation in patients undergoing electrical cardioversion (ECV) for symptomatic atrial fibrillation is important to prevent adverse events. High medication adherence is a requirement. In patients with newly diagnosed atrial fibrillation (n = 169) who were intended to undergo ECV, the aim of this study was to measure self-reported short- and long-term adherence, evaluate whether dabigatran plasma concentrations reflect adherence, measure treatment satisfaction and assess whether adherence and treatment satisfaction are correlated. Methods and results Plasma concentrations (liquid-chromatography tandem mass spectrometry), the 8-point Morisky Medication Adherence Scale (MMAS-8) and the Anti-Clot Treatment Scale (ACTS) were measured after 3 weeks and 7 weeks of treatment. Combined mean peak (1-3 h after intake) and trough (10-16 h after intake) plasma concentrations were 175 (SD 109) ng/mL and 75 (SD 45) ng/mL, respectively. There was no relationship between short-term adherence (last 3 days) or long-term adherence (last 3-4 weeks) and plasma concentrations, unless the last intake was more than 48 h ago. After 7 weeks high, moderate, and low adherence, according to the MMAS-8, was seen in 74%, 21%, and 5% of patients, respectively. Treatment satisfaction was high (median ACTS score 68.5, range 46-75 points). Treatment satisfaction and adherence were not correlated. Conclusion The percentage of patients in the high adherence group (74%) was lower than expected, which is a matter of concern. Dabigatran plasma concentrations could not detect short- or long-term non-adherence, unless the drug was last taken more than 48 h ago. Treatment satisfaction did not correlate with adherence.
AB - Aims Effective anticoagulation in patients undergoing electrical cardioversion (ECV) for symptomatic atrial fibrillation is important to prevent adverse events. High medication adherence is a requirement. In patients with newly diagnosed atrial fibrillation (n = 169) who were intended to undergo ECV, the aim of this study was to measure self-reported short- and long-term adherence, evaluate whether dabigatran plasma concentrations reflect adherence, measure treatment satisfaction and assess whether adherence and treatment satisfaction are correlated. Methods and results Plasma concentrations (liquid-chromatography tandem mass spectrometry), the 8-point Morisky Medication Adherence Scale (MMAS-8) and the Anti-Clot Treatment Scale (ACTS) were measured after 3 weeks and 7 weeks of treatment. Combined mean peak (1-3 h after intake) and trough (10-16 h after intake) plasma concentrations were 175 (SD 109) ng/mL and 75 (SD 45) ng/mL, respectively. There was no relationship between short-term adherence (last 3 days) or long-term adherence (last 3-4 weeks) and plasma concentrations, unless the last intake was more than 48 h ago. After 7 weeks high, moderate, and low adherence, according to the MMAS-8, was seen in 74%, 21%, and 5% of patients, respectively. Treatment satisfaction was high (median ACTS score 68.5, range 46-75 points). Treatment satisfaction and adherence were not correlated. Conclusion The percentage of patients in the high adherence group (74%) was lower than expected, which is a matter of concern. Dabigatran plasma concentrations could not detect short- or long-term non-adherence, unless the drug was last taken more than 48 h ago. Treatment satisfaction did not correlate with adherence.
KW - Antidepressive agents
KW - Atrial fibrillation
KW - Dabigatran
KW - Drug interactions
KW - Mass spectrometry
KW - Medication adherence
KW - Second generation
KW - Prospective Studies
KW - Humans
KW - Self Report
KW - Electric Countershock
KW - Male
KW - Treatment Outcome
KW - Patient Satisfaction
KW - Drug Monitoring/methods
KW - Tandem Mass Spectrometry
KW - Medication Adherence
KW - Time Factors
KW - Dabigatran/administration & dosage
KW - Chromatography, Liquid
KW - Female
KW - Aged
KW - Antithrombins/administration & dosage
KW - Atrial Fibrillation/diagnosis
UR - http://www.scopus.com/inward/record.url?scp=85062969009&partnerID=8YFLogxK
U2 - 10.1093/ehjcvp/pvy047
DO - 10.1093/ehjcvp/pvy047
M3 - Article
C2 - 30608563
AN - SCOPUS:85062969009
VL - 5
SP - 91
EP - 99
JO - European Heart Journal - Cardiovascular Pharmacotherapy
JF - European Heart Journal - Cardiovascular Pharmacotherapy
SN - 2055-6837
IS - 2
ER -