Real-world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in Spain

AimsThis study aimed to identify adherence trajectories and associated factors in atrial fibrillation patients who initiated direct oral anticoagulant (DOAC) therapy, using population-based data from the Catalonia and Valencia regions in Spain during a 2-year follow-up.Methods and ResultsGroup-based...

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Main Authors: L. M. Leguízamo-Martínez, M. E. Ballarin, I. Hurtado, G. Sanfélix-Gimeno, F. Sánchez-Sáez, M. Sabaté
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-07-01
Series:Frontiers in Pharmacology
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Online Access:https://www.frontiersin.org/articles/10.3389/fphar.2025.1562620/full
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author L. M. Leguízamo-Martínez
L. M. Leguízamo-Martínez
L. M. Leguízamo-Martínez
M. E. Ballarin
I. Hurtado
I. Hurtado
G. Sanfélix-Gimeno
G. Sanfélix-Gimeno
F. Sánchez-Sáez
F. Sánchez-Sáez
F. Sánchez-Sáez
M. Sabaté
M. Sabaté
author_facet L. M. Leguízamo-Martínez
L. M. Leguízamo-Martínez
L. M. Leguízamo-Martínez
M. E. Ballarin
I. Hurtado
I. Hurtado
G. Sanfélix-Gimeno
G. Sanfélix-Gimeno
F. Sánchez-Sáez
F. Sánchez-Sáez
F. Sánchez-Sáez
M. Sabaté
M. Sabaté
author_sort L. M. Leguízamo-Martínez
collection DOAJ
description AimsThis study aimed to identify adherence trajectories and associated factors in atrial fibrillation patients who initiated direct oral anticoagulant (DOAC) therapy, using population-based data from the Catalonia and Valencia regions in Spain during a 2-year follow-up.Methods and ResultsGroup-based trajectory modelling (GBTM) was applied to assess adherence patterns in cohorts comprising 14,641 patients in Catalonia and 13,211 in Valencia. Adherence trajectories were categorised based on prescription data, revealing three main trajectories in Valencia and five in Catalonia. Most patients in Valencia demonstrated high adherence, whereas Catalonia showed more varied patterns, including early, gradual, and late declines. Factors associated with non-adherence included high co-insurance levels, alcohol use, and specific DOACs, such as dabigatran.ConclusionAdherence trajectories differed between the two regions, with three identified in Valencia and five in Catalonia. Shared non-adherence patterns were observed across both cohorts, while Catalonia exhibited additional noncompliance trends. Key factors associated with non-adherence included socio-economic variables, clinical characteristics, and the type of DOAC prescribed. Understanding these patterns is essential for developing targeted intervention strategies to improve adherence and optimise treatment outcomes.
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spelling doaj-art-3dca20d7ec2943938da62b456ae025552025-08-20T02:46:28ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122025-07-011610.3389/fphar.2025.15626201562620Real-world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in SpainL. M. Leguízamo-Martínez0L. M. Leguízamo-Martínez1L. M. Leguízamo-Martínez2M. E. Ballarin3I. Hurtado4I. Hurtado5G. Sanfélix-Gimeno6G. Sanfélix-Gimeno7F. Sánchez-Sáez8F. Sánchez-Sáez9F. Sánchez-Sáez10M. Sabaté11M. Sabaté12Department of Clinical Pharmacology, Area Medicament, Hospital Clinic of Barcelona, Barcelona, SpainDepartment of Clinical Pharmacology, Institut d’Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, SpainDepartment of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Barcelona, SpainClinical Pharmacology Service, Vall d’Hebron Hospital Universitari, Vall Hebron Institut de Recerca (VHIR), Barcelona, SpainHealth Services Research and Pharmacoepidemiology Unit, Fundacio per al Foment de la Investigacio Sanitaria i Biomedica (FISABIO), Valencia, SpainRed de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud - RICAPPS, Barcelona, SpainHealth Services Research and Pharmacoepidemiology Unit, Fundacio per al Foment de la Investigacio Sanitaria i Biomedica (FISABIO), Valencia, SpainRed de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud - RICAPPS, Barcelona, SpainHealth Services Research and Pharmacoepidemiology Unit, Fundacio per al Foment de la Investigacio Sanitaria i Biomedica (FISABIO), Valencia, SpainRed de Investigación en Cronicidad, Atención Primaria y Prevención y Promoción de la Salud - RICAPPS, Barcelona, SpainDepartment of Applied Statistics and Operational Research, and Quality, Universitat Politècnica de València, Valencia, SpainDepartment of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona (UAB), Barcelona, SpainClinical Pharmacology Service, Vall d’Hebron Hospital Universitari, Vall Hebron Institut de Recerca (VHIR), Barcelona, SpainAimsThis study aimed to identify adherence trajectories and associated factors in atrial fibrillation patients who initiated direct oral anticoagulant (DOAC) therapy, using population-based data from the Catalonia and Valencia regions in Spain during a 2-year follow-up.Methods and ResultsGroup-based trajectory modelling (GBTM) was applied to assess adherence patterns in cohorts comprising 14,641 patients in Catalonia and 13,211 in Valencia. Adherence trajectories were categorised based on prescription data, revealing three main trajectories in Valencia and five in Catalonia. Most patients in Valencia demonstrated high adherence, whereas Catalonia showed more varied patterns, including early, gradual, and late declines. Factors associated with non-adherence included high co-insurance levels, alcohol use, and specific DOACs, such as dabigatran.ConclusionAdherence trajectories differed between the two regions, with three identified in Valencia and five in Catalonia. Shared non-adherence patterns were observed across both cohorts, while Catalonia exhibited additional noncompliance trends. Key factors associated with non-adherence included socio-economic variables, clinical characteristics, and the type of DOAC prescribed. Understanding these patterns is essential for developing targeted intervention strategies to improve adherence and optimise treatment outcomes.https://www.frontiersin.org/articles/10.3389/fphar.2025.1562620/fulldirect oral anticoagulants (DOACs)adherence trajectoriesatrial fibrillation (AF)group-based trajectory modeling (GBTM)real-world data analysis
spellingShingle L. M. Leguízamo-Martínez
L. M. Leguízamo-Martínez
L. M. Leguízamo-Martínez
M. E. Ballarin
I. Hurtado
I. Hurtado
G. Sanfélix-Gimeno
G. Sanfélix-Gimeno
F. Sánchez-Sáez
F. Sánchez-Sáez
F. Sánchez-Sáez
M. Sabaté
M. Sabaté
Real-world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in Spain
Frontiers in Pharmacology
direct oral anticoagulants (DOACs)
adherence trajectories
atrial fibrillation (AF)
group-based trajectory modeling (GBTM)
real-world data analysis
title Real-world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in Spain
title_full Real-world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in Spain
title_fullStr Real-world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in Spain
title_full_unstemmed Real-world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in Spain
title_short Real-world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in Spain
title_sort real world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in spain
topic direct oral anticoagulants (DOACs)
adherence trajectories
atrial fibrillation (AF)
group-based trajectory modeling (GBTM)
real-world data analysis
url https://www.frontiersin.org/articles/10.3389/fphar.2025.1562620/full
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