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Practices Associated With Dabigatran Adherence: A Persistent Need for Anticoagulation Clinics?
Anticoagulation clinics with robust patient engagement programs and monitoring of warfarin therapy achieve better medication safety and effectiveness. Although a benefit of novel oral anticoagulants, such as dabigatran, is the lack of routine laboratory monitoring requirements, it is unknown if reduced follow-up impacts adherence to therapy. In this mixed methods study, the authors' first collected data on dabigatran adherence for 4,863 patients treated with the medication for non-valvular atrial fibrillation at one of 67 Veterans Health Administration hospitals between 2010 and 2012. The primary outcome at the facility-level was the proportion of patients adherent to dabigatran, defined by a proportion of days covered (PDC) >80%. High-performing sites were defined by a site-level PDC that was greater than the median site-level PDC for the entire cohort. …
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