Background: Adherence to medications is a clinical concern across many chronic illnesses. Adherence and persistence to DOACs for VTE is critical to ensure adequate treatment of the thrombosis and, if used for an extended duration, to prevent new VTE episodes.
Aims: Assess the adherence and persistence to DOACs in patients in the community following admission to hospital with a new VTE.
Methods: We retrospectively reviewed community pharmacy dispensing data on all patients with newly diagnosed VTE and prescribed a DOAC (apixaban or rivaroxaban) between January 2018 and December 2019 at our institution. Proportion of days covered (PDC) was used to assess adherence at 90 days, and 6- and 12-months. Persistence was measured by participants having a dispensed supply of DOAC at the end of the intended treatment period, as long as there were no significant gaps in supply (>60 days). Ethics approval was granted
Results: We identified 225 patients who met inclusion criteria. Overall PDC at 90 days, 6months and 12 months were 84.6%, 86.2% and 86.1% respectively. Apixaban had a higher mean PDC than rivaroxaban, at 86.2% and 80.6% respectively (P < 0.01). Females had a higher PDC than males, 87.3% and 81.2% respectively (p < 0.05). 133 (64%) were persistent with therapy and there were no clinical predictors of improved persistence.
Conclusion(s): In patients with newly diagnosed VTE treated with a DOAC, adherence rates were high at over 80%, with females and those prescribed apixaban having higher adherence. Only two-thirds were persistent with therapy for the intended treatment duration. These findings may assist clinicians in potentially identifying those at risk of poor adherence.
Proportion of days covered -PDC- for rivaroxaban and apixaban at different time points and overall. Mean + standard deviation. ns= not significant; *= P < 0.05.**=P < 0.01, ***= P < 0.005.
Proportion of days covered -PDC- for rivaroxaban and apixaban at different time points and overall.
Proportion of days covered -PDC- for males and females at different time points and overall. Mean + standard deviation. ns= not significant; *= P < 0.05
Proportion of days covered -PDC- for males and females at different time points and overall
To cite this abstract in AMA style:
Dix C, Bortz H, da Gama M, Treloar M, Reynolds M, Day T, Tran H. Adherence and persistence to Direct Oral Anticoagulants (DOACs) in the community following newly diagnosed Venous Thromboembolism (VTE) – a pharmacy-linkage study [abstract]. https://abstracts.isth.org/abstract/adherence-and-persistence-to-direct-oral-anticoagulants-doacs-in-the-community-following-newly-diagnosed-venous-thromboembolism-vte-a-pharmacy-linkage-study/. Accessed October 1, 2023.« Back to ISTH 2022 Congress
ISTH Congress Abstracts - https://abstracts.isth.org/abstract/adherence-and-persistence-to-direct-oral-anticoagulants-doacs-in-the-community-following-newly-diagnosed-venous-thromboembolism-vte-a-pharmacy-linkage-study/