Treatment Persistence in Atrial Fibrillation: The Next Major Hurdle


In the October issue of Thrombosis and Haemostasis, Geng et al reported treatment satisfaction with dabigatran versus warfarin among patients with atrial fibrillation (AF) in China.[1] This time-intensive, patient-centred study with high completion rate of standardized telephone interviews provides high-quality data and key insights from the patients' perspectives. At 6 months, 33.5% of patients had discontinued dabigatran compared with 19.2% for warfarin. The authors report no difference in the global Anti-Clot Treatment Scale (ACTS) Burdens score or the global ACTS Benefits score. The favourable effects of dabigatran regarding decreased concern for dietary or drug interactions and medication-related hassles were offset by the economic burden of dabigatran which is not covered by medical insurance in China. As noted by the authors, the cost of dabigatran is 70 times the cost of warfarin. Factors associated with treatment persistence included older age, longer duration of anticoagulation therapy, global ACTS Benefits score and warfarin therapy.

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Hylek EM et al. Thromb Haemost. 19 November, 2018. Epub ahead of print.