title: Adherence to long-term anticoagulation treatment, what is known and what the future might hold.
abstract: Adherence to medication, commonly reported as being 50% in chronic diseases, is of great concern in healthcare. Medication non-adherence is particularly apparent in chronic diseases, where treatment is often preventative and may provide little or no symptomatic relief or feedback for the patient. A lot of research has been undertaken to describe the extent of non-adherence to long-term anticoagulation therapy, particularly with vitamin K antagonists and more recently with direct oral anticoagulants. However, the literature is scarce with respect to describing adherence to anticoagulation in terms of the behavioural aspects that influence medicine use. Utilizing the COM-B (capability, opportunity, motivation and behaviour) psychological model of non-adherence, we present the available evidence, not only in terms of describing the extent of the non-adherence problem, but also describing why patients do not adhere, offering theory-driven and evidence-based solutions to improve long-term adherence to chronic anticoagulation therapy. Lessons learned are not only applicable within the field of anticoagulation but throughout haematology.
authors.affiliation: Institute of Pharmaceutical Science, King's College London, London, UK.|King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital Foundation NHS Trust, Denmark Hill, London, UK.
authors.forename: John K
authors.identifier: 0000-0002-9294-3174
authors.initials: JK
authors.lastname: Abdou
authors.affiliation: Institute of Pharmaceutical Science, King's College London, London, UK.
authors.forename: Vivian
authors.initials: V
authors.lastname: Auyeung
authors.affiliation: Institute of Pharmaceutical Science, King's College London, London, UK.|King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital Foundation NHS Trust, Denmark Hill, London, UK.
authors.forename: Jignesh P
authors.initials: JP
authors.lastname: Patel
authors.affiliation: King's Thrombosis Centre, Department of Haematological Medicine, King's College Hospital Foundation NHS Trust, Denmark Hill, London, UK.
authors.forename: Roopen
authors.initials: R
authors.lastname: Arya
mesh_terms: D000925:Anticoagulants / Q000627:therapeutic use*; D006801:Humans; D008134:Long-Term Care; D055118:Medication Adherence / Q000523:psychology*; D008960:Models, Psychological
chemical_list: D000925:Anticoagulants
keywords: atrial fibrillation; direct oral anticoagulants; medication adherence; venous thromboembolism; vitamin K antagonists