Journal of Cardiovascular Development and Disease
Primary Non-Adherence and Associated Factors in Patients with Atrial Fibrillation in Germany: A Retrospective Cohort Study
By Karel Kostev, Beate Leppert, Maximilian Peters and 3 others.
Abstract
Background
Primary non-adherence (PNA)—failure to dispense a newly prescribed medication—is an early barrier to effective treatment. This study aimed to estimate PNA to oral anticoagulants in patients with atrial fibrillation (AF) in Germany and to identify associated factors.
Methods
In this retrospective cohort study, first prescriptions of vitamin K antagonists (VKAs), direct thrombin inhibitors, or direct factor Xa inhibitors issued to AF patients between 2016 and 2025 in the IQVIA Disease Analyzer database were combined with pharmacy dispensing records in the Longitudinal Prescription (LRx) database. First prescriptions preceded by a dispensing of the same class within 365 days were excluded. PNA was defined as failure to dispense within 30 days; associated factors were assessed using logistic regression with generalized estimating equations.
