Adherence to long‐term anticoagulation treatment, what is known and what the future might hold. (12th May 2016)

• Record Type: Journal Article
• Authors: Abdou, John K.; Auyeung, Vivian; Patel, Jignesh P.; Arya, Roopen
• Is Part Of: British journal of haematology. Volume 174:Number 1(2016)
• Page Start: 30
• Page End: 42
• Publication Date: 2016-05-12
• Subjects: medication adherence -- vitamin K antagonists -- direct oral anticoagulants -- venous thromboembolism -- atrial fibrillation; Hematology -- Periodicals; Blood -- Diseases -- Periodicals; 616.15
• DOI: 10.1111/bjh.14134
• Languages: English
• ISSNs: 0007-1048

Abstract

Summary: 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.