Patient Preference and Adherence (Jul 2022)
Adherence to Antithrombotic Therapy for Patients Attending a Multidisciplinary Thrombosis Service in Canada – A Cross-Sectional Survey
Abstract
Kwadwo Osei Bonsu,1 Stephanie Young,1,2 Tiffany Lee,1,2 Hai Nguyen,1 Rufaro S Chitsike3,4 1School of Pharmacy, Memorial University of Newfoundland and Labrador, St John’s, NL, A1B 3V6, Canada; 2Pharmacy Program, Eastern Region Health Authority, St John’s, NL, A1B 3V6, Canada; 3Division of Medicine (Hematology), Memorial University of Newfoundland and Labrador, St John’s, NL, A1B 3V6, Canada; 4Division of Hematology, Eastern Region Health Authority, St John’s, NL, A1B 3V6, CanadaCorrespondence: Kwadwo Osei Bonsu, School of Pharmacy, Memorial University of Newfoundland and Labrador, 300 Prince Philip Drive, St John’s, NL, A1B 3V6, Canada, Email [email protected]: Poor medication adherence puts patients who require antithrombotic therapy at greater risk of complications. We started a multidisciplinary Adult Outpatient Thrombosis Service in 2017 in a Canadian health authority and were interested in the level of medication adherence in the population attending.Aim(S): The aim of this study is to assess adherence to antithrombotic medications for patients attending a multidisciplinary Thrombosis Service.Methods: We conducted a cross-sectional survey of outpatients seen at the Thrombosis Service between 2017 and 2019 using the 12-item validated Adherence to Refills and Medications Scale (ARMS) to assess adherence to antithrombotic (anticoagulants and antiplatelet) therapy. Linear regression analysis examined the factors associated with adherence to antithrombotic therapy.Results: Of 1058 eligible patients, 53.2% responded to the survey. Seventeen were excluded from the analysis for missing more than 6 responses to the 12 items on the ARMS. About 55% (n = 297) were on direct oral anticoagulants (DOACs), 19% (n = 102) on warfarin, 5.0% (n = 27) on low molecular weight heparin, 3.3% (n = 18) on antiplatelet therapy and 18% (n = 96) were no longer on antithrombotic therapy. Nearly half (47%, n = 253) had taken antithrombotic therapy for 1– 5 years while 28% (n = 150) and 25% (n = 137) had taken antithrombotic treatments for 5 years, respectively. Most patients (87%, n = 475) were ≥ 50 years and half (51%, n = 277) were male. The mean adherence score was 13.9 (SD± 2.2) and 88% (n = 481) of participants were adherent to antithrombotic treatment (ARMS = 12– 16). Multivariable linear regression showed that patients with post-graduate education had 0.4% lower adherence to antithrombotic therapy as compared with elementary education (β = 0.0039, p = 0.048). Patients with prior antithrombotic agent use > 5 years had 0.5% lower adherence to antithrombotic treatment compared to patients with < 1 year (β = 0.0047, p = 0.0244).Conclusion: Self-reported adherence to antithrombotic therapy was high (88%) within a multidisciplinary Thrombosis Service. Patients with advanced education and prolong duration of antithrombotic therapy were more likely to have lower self-reported adherence to antithrombotic treatment.Keywords: medication adherence, self-reported adherence, multidisciplinary care, thrombosis service, anticoagulation management program, antithrombotic therapy
