System Maintenance Notice

Please note that maintenance work is scheduled between 4 AM and 5 AM - CET. During this time, you may experience reduced performance. Thanks for your patience.

Publications

Journal Article Ahead of print

PubMed: 41223899 DOI: 10.1016/j.ijcard.2025.134020

Knowledge and awareness of nonvalvular atrial fibrillation and anticoagulant therapy: Association with medication adherence in a cross-sectional survey.

Int J Cardiol

Authors: Ayşegül Ülgen Kunak, Mehmet Kaplan, Gönül Açıksarı, Kadir Uğur Mert, Serhat Çalışkan, Zeki Şimşek, Özcan Başaran, Ulaankhuu Batgerel, Muammer Karakayalı, Sinan Demirel, Murat Gök, Zeynep Kolak, Gizem Çabuk, İbrahim Halil Tanboğa, Can Yücel Karabay

Affiliations

  • Medstar Topçular Hospital, Cardiology, Turkey.
  • Gaziantep University Faculty of Medicine, Cardiology, Turkey.
  • Istanbul Medeniyet University Goztepe Training and Research Hospital, Cardiology, Turkey.
  • Eskişehir Osmangazi University Faculty of Medicine, Cardiology, Turkey.
  • İstanbul Bahçelievler Public Hospital, Cardiology, Turkey.
  • Kartal Koşuyolu High Specialization Training and Research Hospital, Cardiology, Turkey.
  • Muğla Sıtkı Kocaman University Faculty of Medicine, Cardiology, Turkey.
  • Kadiköy Acıbadem Hospital, Cardiology, Turkey.
  • Kafkas University Faculty of Medicine, Cardiology, Turkey.
  • Pendik State Hospital, Cardiology, Turkey.
  • Trakya University Faculty of Medicine, Cardiology, Turkey.
  • Dr. Siyami Ersek Thoracic and Cardiovascular Surgery Training and Research Hospital, Cardiology, Turkey.
  • İzmir Tepecik Training and Research Hospital, Cardiology, Turkey.
  • Nişantaşı University Medical School, Biostatistics, Turkey.

Abstract

BACKGROUND

Nonvalvular atrial fibrillation (NVAF) increases the risk of stroke, which can be reduced with oral anticoagulant (OAC) therapy. However, limited patient knowledge about NVAF and its treatment may compromise medication adherence. This study evaluated the association between NVAF knowledge, anticoagulant awareness, and adherence.

METHODS

This sub-analysis of the TRAFFIC (Turkish Registry of Atrial Fibrillation in Cardiovascular Clinics) study included 1659 NVAF patients. Disease and treatment knowledge were assessed with structured questionnaires (score range: 0-14). Adherence was evaluated using three key behaviors (score range: 0-6). Multivariable ordinal logistic regression identified independent predictors of adherence.

RESULTS

The median age was 70 (62-77) years; 48 % were female. Median NVAF knowledge score was 9.0 (7.0-11.0) and anticoagulant knowledge score was 10.0 (7.0-12.0). Overall, 42 % of patients showed high adherence, 20 % medium adherence, and 38 % low adherence. Both NVAF knowledge (r = 0.316, p < 0.001) and anticoagulant knowledge (r = 0.350, p < 0.001) correlated positively with adherence. In multivariable analysis, education level (OR = 1.312, 95 % CI: 1.121-1.535, p = 0.0007), anticoagulant knowledge (OR = 1.564, 95 % CI: 1.295-1.889, p < 0.0001), NVAF knowledge (OR = 1.172, 95 % CI: 0.974-1.410, p = 0.0016), and younger age (OR = 0.804, 95 % CI: 0.700-0.923, p = 0.0006) independently predicted adherence.

CONCLUSIONS

Greater knowledge of NVAF and anticoagulant therapy is significantly associated with higher adherence. Educational interventions addressing specific knowledge gaps, especially regarding disease mechanisms and treatment importance, may enhance adherence and reduce adverse outcomes in NVAF patients.

MeSH

Anticoagulants, Cross-Sectional Studies, Atrial Fibrillation, Cardiology, Medication Adherence, Therapeutics