Abstract:
BACKGROUND:Direct oral anticoagulants (DOACs) are high risk medications with short half-lives making adherence vitally important. Global measures for adherence have been described; however, there is a lack of patient-level data on adherence. METHODS:This prospective, single-center study in an interdisciplinary internal medicine clinic included patients referred by their primary care physician for DOAC therapy evaluation. Patients were interviewed by a clinical pharmacist who confirmed dose and indication. Adherence was evaluated by asking how it was taken, at what time(s) of the day, and how many doses of their DOAC were missed. Labs and concomitant drugs were evaluated and patients received medication counseling. If any issues arose, the pharmacist would work together with the physician to resolve them. FINDINGS:Of 116 visits from 72 patients, an intervention was needed in 79 visits (68·1%). The most common problem identified was related to adherence: non-adherence to timing of dosing (n = 30), non-adherence to frequency of dosing (n = 5), and non-adherence to administration with food when indicated (n = 11). Adherence issues were present in 11 (61·1%) visits in patients taking rivaroxaban and 31 (33·0%) visits in patients taking apixaban. INTERPRETATION:An interdisciplinary DOAC service provided interventions for the majority of patients referred for DOAC therapy evaluation. The most frequent problem was non-adherence, with more than a third of patients found to be non-adherent to the timing of their medication administration.
journal_name
Thromb Resjournal_title
Thrombosis researchauthors
Talana AS,Huber K,Sorin M,Stalvey C,Davis K,Dietrich Edoi
10.1016/j.thromres.2019.04.021subject
Has Abstractpub_date
2019-07-01 00:00:00pages
34-36eissn
0049-3848issn
1879-2472pii
S0049-3848(19)30214-2journal_volume
179pub_type
信件abstract::Despite clear potential benefits of outpatient care, most patients suffering from pulmonary embolism (PE) are currently hospitalized due to the fear of possible adverse events. Nevertheless, some teams have increased or envisage to increase outpatient treatment or early discharge. We performed a narrative systematic r...
journal_title:Thrombosis research
pub_type: 杂志文章,评审
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/s0049-3848(01)00370-x
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journal_title:Thrombosis research
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(88)90094-1
更新日期:1988-10-15 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2014.12.021
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(94)90270-4
更新日期:1994-06-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(94)90173-2
更新日期:1994-09-15 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
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更新日期:1982-09-15 00:00:00
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journal_title:Thrombosis research
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journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2013.12.037
更新日期:2014-04-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2014-03-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(94)90224-0
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pub_type: 杂志文章
doi:10.1016/j.thromres.2011.05.007
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journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/s0049-3848(02)00149-4
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doi:10.1016/j.thromres.2018.01.003
更新日期:2018-04-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2011.12.026
更新日期:2012-03-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(90)90105-l
更新日期:1990-11-15 00:00:00
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journal_title:Thrombosis research
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journal_title:Thrombosis research
pub_type: 杂志文章
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journal_title:Thrombosis research
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1986-06-15 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(85)90209-9
更新日期:1985-06-15 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(90)90198-l
更新日期:1990-01-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(87)90222-2
更新日期:1987-02-15 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(87)90376-8
更新日期:1987-07-15 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(85)90037-4
更新日期:1985-01-01 00:00:00
abstract::Incubation of recombinant human tissue factor apoprotein (Apo-TF) with human plasma decreased the recalcified clotting time of this plasma in a time-and dose-dependent manner suggesting relipidation of the Apo-TF by plasma lipoproteins. Incubation of Apo-TF with purified preparations of human very low density, low den...
journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(90)90182-c
更新日期:1990-11-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
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更新日期:2010-03-01 00:00:00