PREDICTORS OF NONADHERENCE WITH THERAPY IDENTIFIED

Anticoagulation providers may be ableto identify patients who are likely to benonadherent with their anticoagulationtherapy. Warfarin nonadherence is a significantproblem because patients whodo not take warfarin correctly put themselvesat significant risk of having bleedingor thromboembolic events.A study of75 patients at a low-income outpatientanticoagulation clinic identified severalfactors that were associated with nonadherence.Perceived barriers to therapy(eg, concerns about bleeding, forgetting),marital status (single), living arrangements(living in a shelter or staying withfriends), and drug regimen (alternatingdoses) all played a significant role in nonadherence.Outcomes were measuredby using short questionnaires based onthe Health Belief and Patient SatisfactionModels. Refill records and patient selfreportswere also analyzed to determineadherence to medications.

Although the study included a smallnumber of patients in a limited geographicarea, the results may help raise awarenessof circumstances that may adverselyaffect adherence. They may also allowclinicians to identify those patients whomay require extra effort to help themachieve positive outcomes of therapy.

Dr. Garrett is a clinical pharmacistpractitioner at Cornerstone HealthCare in High Point, NC.