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Master Thesis

Observance des anticoagulants oraux dans la fibrillation atriale, enquête auprès des médecins généralistes des Hautes-Alpes

Abstract : Background: Atrial fibrillation (AF) is a common, severe and costly pathology. Stroke prevention is central to the management of these patients. Direct oral anticoagulants (DOAC) reduce the risk of stroke in moderate to high-risk patients with non-valvular atrial fibrillation (AF). Yet, concerns remain regarding its routine use in real world practice. We sought to describe DOAC adherence and quality of life, among outpatients with AF. Methods: We performed a transversal observational monocentric study of patients taking DOAC for non-valvular AF between March and July 2017 in the french department of Hautes-Alpes. Adherence was determined using the 8-items Morisky score and the quality of life was assessed by the Anti-Clot Treatment Scale (ACTS). Results and conclusions: A total of 84 patients were included. In a real-world rural population being prescribed DOAC for AF, more than one third had sub-optimal adherence. Being treated for more than 5 years (p=0.04) or the fact that general practitioner was the first prescriber (p=0.03) were associated with high adherence. Good knowledge about AF and treatment (p=0.11) and ACTS Burdens and Benefits scale (p=0.12 and 0.13) tended to be associated with high adherence. 5 or more additional drug use (p=0.02), CHA2DS2-VASc ≥4 (p=0.02) and HAS-BLED ≥3 (p=0.02) were associated with low or medium adherence to DOAC. Twice or daily regimen didn’t impact on adherence (p=0.49). Efforts identifying non-adherent patients, and targeted adherence interventions are needed to improve outcomes.
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https://dumas.ccsd.cnrs.fr/dumas-01907866
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Submitted on : Monday, October 29, 2018 - 3:41:23 PM
Last modification on : Monday, July 6, 2020 - 4:46:58 PM
Long-term archiving on: : Wednesday, January 30, 2019 - 4:36:37 PM

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Paul Lemiere. Observance des anticoagulants oraux dans la fibrillation atriale, enquête auprès des médecins généralistes des Hautes-Alpes. Sciences du Vivant [q-bio]. 2017. ⟨dumas-01907866⟩

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