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 < 0.001). This disparity was independent of the number of drugs consumed for any reason, since prevalence of poly-therapy among the three macro-regions was similar. Our results show regional differences in NVAF patients' antithrombotic management and medication adherence, potentially reflecting well-known disparities in socioeconomic status among Italian regions. Future interventions promoting campaigns to global health-care education may be desirable to improve clinical outcomes in NVAF patients.
Raparelli, V., Proietti, M., Buttà, C., Di Giosia, P., Sirico, D., Gobbi, P., et al. (2014). Medication prescription and adherence disparities in non valvular atrial fibrillation patients: an Italian portrait from the ARAPACIS study. INTERNAL AND EMERGENCY MEDICINE, 9(8), 861-870 [10.1007/s11739-014-1096-1].
|Citazione:||Raparelli, V., Proietti, M., Buttà, C., Di Giosia, P., Sirico, D., Gobbi, P., et al. (2014). Medication prescription and adherence disparities in non valvular atrial fibrillation patients: an Italian portrait from the ARAPACIS study. INTERNAL AND EMERGENCY MEDICINE, 9(8), 861-870 [10.1007/s11739-014-1096-1].|
|Tipo:||Articolo in rivista - Articolo scientifico|
|Carattere della pubblicazione:||Scientifica|
|Presenza di un coautore afferente ad Istituzioni straniere:||No|
|Titolo:||Medication prescription and adherence disparities in non valvular atrial fibrillation patients: an Italian portrait from the ARAPACIS study|
|Autori:||Raparelli, V; Proietti, M; Buttà, C; Di Giosia, P; Sirico, D; Gobbi, P; Corrao, S; Davì, G; Vestri, A; Perticone, F; Corazza, G; Violi, F; Basili, S; Annoni, G; Castagna, A|
|Data di pubblicazione:||2014|
|Rivista:||INTERNAL AND EMERGENCY MEDICINE|
|Digital Object Identifier (DOI):||http://dx.doi.org/10.1007/s11739-014-1096-1|
|Appare nelle tipologie:||01 - Articolo su rivista|