Mental health conditions and adherence to direct oral anticoagulants in patients with incident atrial fibrillation : A nationwide cohort study

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Teppo , K , Jaakkola , J , Airaksinen , K E J , Biancari , F , Halminen , O , Putaala , J , Mustonen , P , Haukka , J , Hartikainen , J , Luojus , A , Niemi , M , Linna , M & Lehto , M 2022 , ' Mental health conditions and adherence to direct oral anticoagulants in patients with incident atrial fibrillation : A nationwide cohort study ' , General Hospital Psychiatry , vol. 74 , pp. 88-93 . https://doi.org/10.1016/j.genhosppsych.2021.12.012

Title: Mental health conditions and adherence to direct oral anticoagulants in patients with incident atrial fibrillation : A nationwide cohort study
Author: Teppo, Konsta; Jaakkola, Jussi; Airaksinen, K. E. Juhani; Biancari, Fausto; Halminen, Olli; Putaala, Jukka; Mustonen, Pirjo; Haukka, Jari; Hartikainen, Juha; Luojus, Alex; Niemi, Mikko; Linna, Miika; Lehto, Mika
Contributor organization: HUS Heart and Lung Center
HUS Neurocenter
Clinicum
Department of Neurosciences
Neurologian yksikkö
Jari Haukka / Principal Investigator
Department of Public Health
University of Helsinki
HUSLAB
Department of Clinical Pharmacology
Medicum
Department of Diagnostics and Therapeutics
INDIVIDRUG - Individualized Drug Therapy
HUS Diagnostic Center
Date: 2022
Language: eng
Number of pages: 6
Belongs to series: General Hospital Psychiatry
ISSN: 0163-8343
DOI: https://doi.org/10.1016/j.genhosppsych.2021.12.012
URI: http://hdl.handle.net/10138/339938
Abstract: Objective: Medication adherence is essential for effective stroke prevention in patients with atrial fibrillation (AF). We aimed to assess whether adherence to direct oral anticoagulants (DOACs) in AF patients is affected by the presence of mental health conditions (MHCs). Methods: The nationwide FinACAF cohort covered 74,222 AF patients from all levels of care receiving DOACs during 2011-2018 in Finland. Medication possession ratio (MPR) was used to quantify adherence. Patients with MPR >= 0.90 were defined adherent. MHCs of interest were depression, bipolar disorder, anxiety disorder and schizophrenia. Results: The patients' (mean age 75.4 +/- 9.5 years, 50.8% female) mean MPR was 0.84 (SD 0.22), and 59.5% had MPR >= 0.90. Compared to patients without MHC, the adjusted ORs (95% CI) for adherent DOAC use emerged slightly lower in patients with depression (0.92 (0.84-0.99)) and bipolar disorder (0.77 (0.61-0.97)) and unsignificant in patients with anxiety disorder (1.08 (0.96-1.21)) and schizophrenia (1.13 (0.90-1.43)). However, when only persistent DOAC therapy was analyzed, no MHC was associated with poor adherence, and instead anxiety disorder was associated with adherent DOAC use (1.18 (1.04-1.34)). Conclusion: Adherence to DOACs in AF patients in Finland was relatively high, and no meaningful differences between patients with and without MHCs were observed.
Subject: Adherence
Implementation
Direct oral anticoagulant
Mental health condition
Depression
Atrial fibrillation
Psychiatric disorder
MEDICATION ADHERENCE
PERSISTENCE
DISORDER
WARFARIN
BURDEN
RISK
3124 Neurology and psychiatry
Peer reviewed: Yes
Rights: cc_by
Usage restriction: openAccess
Self-archived version: publishedVersion


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