title: Adherence to medication and characteristics of Japanese patients with non-valvular atrial fibrillation.
abstract: BACKGROUND
  Adherence to medication plays an important role in the prevention of morbidity and mortality in non-valvular atrial fibrillation (NVAF) patients. The aim of this study is to assess adherence to medication and risk factors for non-adherence in Japanese NVAF patients who are prescribed anticoagulants.
  
  
  METHODS
  A total of 378 outpatients with NVAF who completed self-reported questionnaires were analyzed in this prospective study (mean age 69±12 years; 26% female). Self-reported adherence to cardiovascular drugs including anticoagulants was measured with a modified Siegal scale. Depression was defined as a Patient Health Questionnaire-9 score of ≥10. Univariate and multivariate analyses were performed on several variables to analyze factors affecting non-adherence.
  
  
  RESULTS
  In total, 291 (77%) of our patients received warfarin, and the remainder received direct oral anticoagulants. Fifty-two (14%) patients were defined as non-adherent. Univariate analyses showed that age <65 years, ≥2 times daily dosing of cardiovascular drugs and employment, but not depression, were significantly associated with non-adherence, 1.87 (95% CI: 1.01-3.42, p=0.04), 2.97 (95% CI: 1.64-5.49, p<0.01), 2.11 (95% CI: 1.16-3.93, p=0.01), and 0.74 (95% CI: 0.26-2.64), respectively. Multivariate analysis showed that only ≥2 times daily dosing was a significant independent risk factor (HR 3.06, 95% CI: 1.67-5.69, p<0.01).
  
  
  CONCLUSIONS
  Our study showed that the prevalence of non-adherence to medications was 14% in NVAF patients. Frequent daily dosing was an independent risk factor for non-adherence to medication (UMIN-CTR No. UMIN 000023514).
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan. Electronic address: mshiga@hij.twmu.ac.jp.
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Shiga
authors.affiliation: Department of Medicine, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
authors.forename: Hisako
authors.initials: H
authors.lastname: Omori
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University Aoyama Hospital, Tokyo, Japan.
authors.forename: Fujio
authors.initials: F
authors.lastname: Tatsumi
authors.affiliation: Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Katsuji
authors.initials: K
authors.lastname: Nishimura
authors.affiliation: Department of Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Hagiwara
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage* / Q000627:therapeutic use; D044466:Asian People; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000523:psychology; D003863:Depression / Q000188:drug therapy / Q000523:psychology; D004334:Drug Administration Schedule; D005260:Female; D006801:Humans; D008297:Male; D055118:Medication Adherence / Q000523:psychology; D008875:Middle Aged; D012307:Risk Factors; D014859:Warfarin / Q000008:administration & dosage* / Q000627:therapeutic use; D016903:Drug Monitoring
chemical_list: D000925:Anticoagulants; D014859:Warfarin
keywords: Adherence; Anticoagulants; Atrial fibrillation; Japanese