Long-term persistence and adherence with direct oral anticoagulants vs. warfarin in atrial fibrillation patients.

Project number: 
17-149
Approval date: 
Monday, November 20, 2017
Principal Investigator: 
Loewen,Peter
Institution: 
University of British Columbia (UBC)
Funding Agency: 
Canadian Cardiovascular Society
Datasets requested: 
Not available
Research objective: 

Research questions:
1. What is the prevalence and pattern of persistence with OAC therapy in AF patients?
2. What is the prevalence and pattern of adherence to OAC therapy in AF patients?
3. How are non-adherence and non-persistence to OAC therapy in AF patients associated with mortality, stroke, bleeding, health care utilization, and cost?
4. How is the Quality of INR control associated with mortality, stroke, bleeding, health care utilization, and cost?

Hypotheses:
1. Persistence with new oral anticoagulants (NOACs; dabigatran, rivaroxaban, apixaban, edoxaban) is superior to persistence with warfarin in atrial fibrillation (AF) patients.
2. AF patients are more adherent to NOAC therapy than warfarin.
3. Poor adherence to OAC therapy is associated with adverse outcomes including mortality, comorbidities (i.e. stroke), higher health care utilization (i.e. hospitalizations, outpatient visits), and higher costs.
4. Unstable INR is associated with adverse outcomes including mortality, comorbities and higher health care utilization.


Page last revised: December 5, 2017