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首页> 外文期刊>Journal of stroke and cerebrovascular diseases: The official journal of National Stroke Association >Insights Into Direct Oral Anticoagulant Therapy Implementation of Stroke Survivors with Atrial Fibrillation in an Ambulatory Setting
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Insights Into Direct Oral Anticoagulant Therapy Implementation of Stroke Survivors with Atrial Fibrillation in an Ambulatory Setting

机译：在动态环境中具有心房颤动的中风避孕药直接口服抗凝治疗的洞察

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Objectives: To describe how stroke survivors with atrial fibrillation implement direct oral anticoagulant treatment and propose appropriate metrics to describe adherence. Materials and Methods: Stroke patients with atrial fibrillation electronically recorded their self-administered direct oral anticoagulants (apixaban, dabigatran, edoxaban, rivaroxaban) during a 6-month observation phase after hospitalisation for ischemic stroke. Taking and timing adherence, correct dosing days, drug holidays, time of the day and day of the week subsets, dose-to-dose intervals and longest intervals between two consecutive doses were calculated from electronic monitoring data to describe and discuss the implementation phase of adherence. Results: Data from 41 patients were analysed. Median age was 77 (IQR = 69-84), 63.4% were male and the majority suffered a mild stroke (median NIHSS: 1). Mean taking and timing adherence exceeded 90%. Correct dosing occurred in 86.6% of the days. Seven patients (17.1%) had intake pauses of three or more consecutive days. Patients with twice-daily regimen (70.7%) had higher taking adherence in the morning than in the evening (94.4% versus 89.9%; p = 0.001). No therapy- or anamneses-related characteristic was associated with taking adherence. Conclusions: Although adherence to direct oral anticoagulants of stroke patients with atrial fibrillation exceeded 90%, deviant intake patterns such as drug holidays and missed evening doses were common and raise concerns. Appropriate adherence metrics calculated from electronic monitoring data may guide healthcare professionals elucidating patient-tailored adherence-enhancing interventions.
机译：目的：描述患有房颤的中风幸存者如何实施直接口服抗凝治疗，并提出适当的指标来描述依从性。材料和方法：患有心房颤动的中风患者在因缺血性中风住院后的6个月观察期内，通过电子记录他们自己服用的直接口服抗凝剂（阿哌沙班、达比加群、依多沙班、利伐沙班）。根据电子监测数据计算服药和时间依从性、正确的给药天数、药物节假日、一天中的时间和一周中的时间子集、剂量-剂量间隔和两次连续给药之间的最长间隔，以描述和讨论依从性的实施阶段。结果：对41例患者的数据进行了分析。中位年龄为77岁（IQR=69-84），63.4%为男性，大多数人患有轻度中风（NIHSS中位数：1）。平均服用量和时间依从性超过90%。在86.6%的天数内出现了正确的剂量。7名患者（17.1%）连续三天或更长时间暂停进食。每日两次服药的患者（70.7%）早上的服药依从性高于晚上（94.4%对89.9%；p=0.001）。服用依从性与治疗或记忆相关特征无关。结论：虽然患有房颤的中风患者对直接口服抗凝剂的依从性超过90%，但药物休假和错过晚上剂量等异常摄入模式是常见的，并引起关注。根据电子监测数据计算出的适当依从性指标可以指导医疗专业人员阐明患者定制的依从性增强干预措施。

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