Cognitive function and adherence to anticoagulation treatment in patients with atrial fibrillation
نویسندگان
چکیده
BACKGROUND Medication adherence is an integral part of the comprehensive care of patients with atrial fibrillation (AF) receiving oral anticoagulations (OACs) therapy. Many patients with AF are elderly and may suffer from some form of cognitive impairment. This study was conducted to investigate whether cognitive impairment affects the level of adherence to anticoagulation treatment in AF patients. METHODS The study involved 111 AF patients (mean age, 73.5 ± 8.3 years) treated with OACs. Cognitive function was assessed using the Mini Mental State Examination (MMSE). The level of adherence was assessed by the 8-item Morisky Medication Adherence Scale (MMAS-8). Scores on the MMAS-8 range from 0 to 8, with scores < 6 reflecting low adherence, 6 to < 8 medium adherence, and 8 high adherence. RESULTS 46.9% of AF patients had low adherence, 18.8% had moderate adherence, and 33.3% had high adherence to OACs. Patients with lower adherence were older than those with moderate or high adherence (76.6 ± 8.7 vs. 71.3 ± 6.4 vs. 71.1 ± 6.7 years) and obtained low MMSE scores, indicating cognitive disorders or dementia (MMSE = 22.3 ± 4.2). Patients with moderate or high adherence obtained high MMSE test results (27.5 ± 1.7 and 27.5 ± 3.6). According to Spearman's rank correlation, worse adherence to treatment with OACs was determined by older age (rS = -0.372) and lower MMSE scores (rS = 0.717). According to multivariate regression analysis, the level of cognitive function was a significant independent predictor of adherence (b = 1.139). CONCLUSIONS Cognitive impairment is an independent determinant of compliance with pharmacological therapy in elderly patients with AF. Lower adherence, beyond the assessment of cognitive function, is related to the age of patients.
منابع مشابه
Investigation of the relationship between pharmacological knowledge of anticoagulants with medication adherence in the elderly patients with atrial fibrillation
Introduction and Aim: In the elderly, the rate of adherence to the medication regimen and the rate of remembering how to correctly prescribe medication is low due to old age and memory loss, which leads to poor therapeutic results. The aim of this study was to determine the relationship between anticoagulants knowledge and adherence to treatment in elderly cardiac patients with atrial fibrillat...
متن کاملDouble-edged blinde, hemorrhagic or cardioembolic cognitive impairment
I have read the article entitled “Cognitive function and adherence to anticoagulation treatment in patients with atrial fibrillation” by Jankowska-Polańska, et al., with great interest. The investigators reported that cognitive impairment is an independent determinant of compliance with pharmacological therapy in elderly patients with atrial fibrillation (AF). Lower adherence, beyond the assess...
متن کاملفرآیند درمانی فیبریلاسیون دهلیزی در بیمارستان های ایران
Background: Lack of attention to standardized guidelines has caused tragic outcome in patients with atrial fibrillation and ultimately increase of financial burden imposed on the community structure of the economic system. Therefore, the present study was aimed to assess the exposure of patients with atrial fibrillation. Methods: A total of 506 patients with atrial fibrillation were...
متن کاملAdherence to oral anticoagulant therapy in patients with atrial fibrillation. Focus on non-vitamin K antagonist oral anticoagulants.
Oral anticoagulation is pivotal in the management of thromboembolic risk in non-valvular atrial fibrillation (NVAF) patients. Effective anticoagulation is important to avoid major adverse events and medication adherence is central to achieve good anticoagulation control. Non-vitamin K antagonist oral anticoagulants (NOACs) are as effective and safe as vitamin K antagonist (VKAs) in NVAF patient...
متن کاملWarfarin versus aspirin for prevention of cognitive decline in atrial fibrillation: randomized controlled trial (Birmingham Atrial Fibrillation Treatment of the Aged Study).
BACKGROUND AND PURPOSE Atrial fibrillation is associated with decline of cognitive function. Observational evidence suggests that anticoagulation might protect against this decline. We report the first randomized controlled trial evidence on the effect of anticoagulation on cognitive function in elderly patients with atrial fibrillation. METHODS A total of 973 patients aged≥75 years with atri...
متن کامل