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Adherence and persistence in the use of warfarin after hospital discharge among patients with heart failure and atrial fibrillation.

Publication ,  Journal Article
Eapen, ZJ; Mi, X; Qualls, LG; Hammill, BG; Fonarow, GC; Turakhia, MP; Heidenreich, PA; Peterson, ED; Curtis, LH; Hernandez, AF; Al-Khatib, SM
Published in: J Card Fail
January 2014

BACKGROUND: Postdischarge adherence and long-term persistence in the use of warfarin among patients with heart failure and atrial fibrillation without contraindications have not been fully described. METHODS AND RESULTS: We identified patients with heart failure and atrial fibrillation who were ≥ 65 years old, eligible for warfarin, and discharged home from hospitals in the Get With the Guidelines-Heart Failure registry from January 1, 2006, to December 31, 2009. We used linked Medicare prescription drug event data to measure adherence and persistence. The main outcome measures were rates of prescription at discharge, outpatient dispensing, discontinuation, and adherence as measured by the medication possession ratio. We hypothesized that adherence to warfarin would differ according to whether patients received the prescription at discharge. Among 2,691 eligible patients, 1,856 (69.0%) were prescribed warfarin at discharge. Patients prescribed warfarin at discharge had significantly higher prescription fill rates within 90 days (84.5% vs 12.3%; P < .001) and 1 year (91.6% vs 16.8%; P < .001) and significantly higher medication possession ratios (0.78 vs 0.63; P < .001). Among both previous nonusers and existing users, fill rates at 90 days and 1 year and possession ratios were significantly higher among those prescribed warfarin at discharge. CONCLUSIONS: One-third of eligible patients with heart failure and atrial fibrillation were not prescribed warfarin at discharge from a heart failure hospitalization, and few started therapy as outpatients. In contrast, most patients who were prescribed warfarin at discharge filled the prescription within 90 days and remained on therapy at 1 year.

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Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

January 2014

Volume

20

Issue

1

Start / End Page

23 / 30

Location

United States

Related Subject Headings

  • Warfarin
  • United States
  • Stroke
  • Registries
  • Patient Discharge
  • Outpatients
  • Outcome Assessment, Health Care
  • Medication Adherence
  • Medicare
  • Male
 

Citation

APA
Chicago
ICMJE
MLA
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Eapen, Z. J., Mi, X., Qualls, L. G., Hammill, B. G., Fonarow, G. C., Turakhia, M. P., … Al-Khatib, S. M. (2014). Adherence and persistence in the use of warfarin after hospital discharge among patients with heart failure and atrial fibrillation. J Card Fail, 20(1), 23–30. https://doi.org/10.1016/j.cardfail.2013.11.006
Eapen, Zubin J., Xiaojuan Mi, Laura G. Qualls, Bradley G. Hammill, Gregg C. Fonarow, Mintu P. Turakhia, Paul A. Heidenreich, et al. “Adherence and persistence in the use of warfarin after hospital discharge among patients with heart failure and atrial fibrillation.J Card Fail 20, no. 1 (January 2014): 23–30. https://doi.org/10.1016/j.cardfail.2013.11.006.
Eapen ZJ, Mi X, Qualls LG, Hammill BG, Fonarow GC, Turakhia MP, et al. Adherence and persistence in the use of warfarin after hospital discharge among patients with heart failure and atrial fibrillation. J Card Fail. 2014 Jan;20(1):23–30.
Eapen, Zubin J., et al. “Adherence and persistence in the use of warfarin after hospital discharge among patients with heart failure and atrial fibrillation.J Card Fail, vol. 20, no. 1, Jan. 2014, pp. 23–30. Pubmed, doi:10.1016/j.cardfail.2013.11.006.
Eapen ZJ, Mi X, Qualls LG, Hammill BG, Fonarow GC, Turakhia MP, Heidenreich PA, Peterson ED, Curtis LH, Hernandez AF, Al-Khatib SM. Adherence and persistence in the use of warfarin after hospital discharge among patients with heart failure and atrial fibrillation. J Card Fail. 2014 Jan;20(1):23–30.
Journal cover image

Published In

J Card Fail

DOI

EISSN

1532-8414

Publication Date

January 2014

Volume

20

Issue

1

Start / End Page

23 / 30

Location

United States

Related Subject Headings

  • Warfarin
  • United States
  • Stroke
  • Registries
  • Patient Discharge
  • Outpatients
  • Outcome Assessment, Health Care
  • Medication Adherence
  • Medicare
  • Male