Medication prescription and adherence disparities in non valvular atrial fibrillation patients: an Italian portrait from the ARAPACIS study

Valeria Raparelli, Marco Proietti, Carmelo Buttà, Paolo Di Giosia, Domenico Sirico, Paolo Gobbi, Salvatore Corrao, Giovanni Davì, Anna Rita Vestri, Francesco Perticone, Gino Roberto Corazza, Francesco Violi, Stefania Basili

Research output: Contribution to journalArticlepeer-review

Abstract

Non-valvular atrial fibrillation (NVAF) represents a major health-care problem, needing an extensive and strict thrombosis prevention for stroke and cardiovascular (CV) disease risks. NVAF management guidelines recommend adequate antithrombotic and anti-atherosclerotic therapies. Medication adherence has been recognized as a pivotal element in health quality promotion and in the achievement of better clinical outcomes. We conducted a post-hoc analysis of the “Atrial fibrillation Registry for Ankle-brachial index Prevalence Assessment-Collaborative Italian Study (ARAPACIS)” with the aim of discerning differences in pharmacological management and medication adherence among NVAF Italian patients. Furthermore, data were analysed according to Italian geographical macro-regions (North, Center, South) to evaluate whether socioeconomic conditions might also influence medication adherence. Thus, we selected 1,366 NVAF patients that fulfilled the Morisky Medication Adherence Scale-4 items. Regional disparities in drug prescriptions were observed. In particular, in high-risk patients (CHA2DS2–VASc ≥2) oral anticoagulants were more prescribed in Northern and Center patients (61 and 60 %, respectively) compared to 53 % of high-risk Southern patients. Also, medication adherence showed a progressive decrease from North to South (78 vs. 60 %, p 

Original languageEnglish
Pages (from-to)861-870
Number of pages10
JournalInternal and Emergency Medicine
Volume9
Issue number8
DOIs
Publication statusPublished - Nov 22 2014

Keywords

  • Antithrombotics
  • Drugs prescription
  • Geographical differences
  • Medication adherence
  • Non valvular atrial fibrillation
  • Socioeconomic status

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine

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