Introduction: Older people mostly found unable to adhere with warfarin treatment guidelines. The health service system is challenged in order to improve medication adherence in older population under limited health resources. The purpose of this study was to explore health systems factors on warfarin adherence in older population, particularly in resources constraint setting.
Methods: This study was a cross-sectional predictive study that enrolled older people who experienced atrial fibrillation (AF) and treated by warfarin, aged 60 years and over, and followed up at the warfarin clinic.
Results: A total of 197 participants with the mean age of 72.03 years (SD = 8.84) was recruited. Almost of them (85.8%) reported adhered to warfarin prescription. More than a half (60.5%) were able to report their targeted INR. Participants who stayed with the family had 5.54 times (95% CI 1.79-19.33), took regular daily dose warfarin had 5.07 times (95% CI 1.05-24.49), perceived targeted INR had 2.94 times (95% CI 1.04-8.29), and received family support had 1.33 times (95% CI 1.11-1.60) increased odds of warfarin adherence than those who did not. Participants who perceived a barrier to taking medication had 0.93 times decreased odds of warfarin adherence than those who did not (95% CI 0.86-0.99).
Conclusion: Healthcare system should encourage family to support the older population with AF in order to increase warfarin adherence. Future research should develop intervention combining family support to promote warfarin adherence.
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http://dx.doi.org/10.2147/JMDH.S472597 | DOI Listing |
Background: Atrial fibrillation (AF) is associated with cognitive decline. Use of oral anticoagulant (OAC) medications offers a lower risk of dementia, but it is unclear whether differences exist between types of OAC agents.
Objective: This was a secondary analysis to explore whether the progression from normal cognition to mild cognitive impairment to dementia differs between adults with AF on warfarin versus non-vitamin K inhibitors medications (NOACs) using data extracted from the National Alzheimer's Coordinating Center clinical case series.
PLoS One
December 2024
Inova Schar Heart and Vascular, Falls Church, VA, United States of America.
Introduction: Use of oral anticoagulants (OACs) for stroke reduction in atrial fibrillation (AF) varies by race and geography within the United States. We seek to better understand the relationship between OAC underutilization, race, and US geography.
Methods: Patients with AF were selected from the US Centers for Medicare & Medicaid Services claims database from January 1, 2013, to December 31, 2016.
Can Pharm J (Ott)
December 2024
Pharmacy Association of Nova Scotia, Halifax, Nova Scotia.
Background: Despite the shift towards direct-acting anticoagulants, warfarin remains widely used in Canada and is traditionally managed by family physicians through laboratory-based international normalized ratio (INR) testing. The Community Pharmacy Anticoagulation Management Service (CPAMS) in Nova Scotia represents an innovative approach, enabling community pharmacists to conduct point-of-care (POC) INR testing and manage warfarin therapy. A potential benefit of this approach is the opportunity to identify non-warfarin medication therapy problems (nwMTPs) during routine visits.
View Article and Find Full Text PDFInt J Stroke
November 2024
Irish National Audit of Stroke, National Office of Clinical Audit. St Stephen's Green, Dublin 2. Ireland.
Background: Atrial Fibrillation (AF) causes up to 20% of ischaemic strokes and 30% in some populations such as those over 80 years. Previous research in our population showed that widespread adoption of Direct Oral Anticoagulant (DOAC) prophylaxis had not been associated with a reduction in AF associated stroke prevalence but there was a considerable rate of breakthrough stroke in patients receiving anticoagulation and anticoagulation rate may be affected by increasing use of DOACs.
Aims: We undertook a more detailed study using the Irish National Audit of Stroke (INAS) to determine the characteristics of anticoagulation practice in AF associated stroke, particularly breakthrough stroke, adherence to prescribing guidelines and effect on thrombolysis rate.
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