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Anticoagulation providers may be able to identify patients who are likely to be nonadherent with their anticoagulation therapy. Warfarin nonadherence is a significant problem because patients who do not take warfarin correctly put themselves at significant risk of having bleeding or thromboembolic events.A study of 75 patients at a low-income outpatient anticoagulation clinic identified several factors 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 with friends), and drug regimen (alternating doses) all played a significant role in nonadherence. Outcomes were measured by using short questionnaires based on the Health Belief and Patient Satisfaction Models. Refill records and patient selfreports were also analyzed to determine adherence to medications.
Although the study included a small number of patients in a limited geographic area, the results may help raise awareness of circumstances that may adversely affect adherence. They may also allow clinicians to identify those patients who may require extra effort to help them achieve positive outcomes of therapy.
Dr. Garrett is a clinical pharmacist practitioner at Cornerstone Health Care in High Point, NC.