Adherence Gap in Use of Warfarin

Updated:Mar 13,2014
American Heart Association/American Stroke Association
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Adherence Gap in Use of Warfarin
Adherence and Persistence in the Use of Warfarin After Hospital Discharge Among Patients With Heart Failure and Atrial Fibrillation. Zubin J. Eapen, MD, Xiaojuan Mi, Laura G. Qualls, Bradley G. Hammill, Gregg C. Fonarow, Mintu P. Turakhia, Paul A. Heidenreich, Eric D. Peterson, Lesley H. Curtis, Adrian F. Hernandez, Sana M. Al-Khatib. J Cardiac Fail 2014;20:23e30 *AHA Young Investigator Research Seed Grant Award Winner*

Key Points:
  • Post discharge adherence and long-term persistence in the use of warfarin among patients with heart failure and atrial fibrillation without contraindications have not been fully described.
  • We identified patients with heart failure and atrial fibrillation in the Get With the Guidelines®-Heart Failure registry and used linked Medicare prescription drug event data to measure adherence and persistence.
  • One-third of eligible patients with heart failure and atrial fibrillation were not prescribed warfarin at discharge from a heart failure hospitalization, and few started therapy as outpatients.
  • In contrast, most patients who were prescribed warfarin at discharge filled the prescription within 90 days and remained on therapy at 1 year.
Study Author:

image for Zupin EapenZubin Eapen, MD, MHS is an Assistant Professor of Medicine at Duke University, Medical Director of the Duke Heart Failure Same Day Access Clinic, and the Department of Medicine Director of Education IT Innovations. He is also a member of Duke Clinical Research Institute Health Services Research Group and Center for Educational Excellence. Dr. Eapen obtained his medical degree and completed his residency and Cardiology Fellowship at Duke University. In 2011-2012, he served as Chief Fellow of both the Duke Clinical Research Institute Fellowship Program and Duke Cardiovascular Disease Fellowship Program. His particular interests include improving care coordination, disease management, and quality of care for patients with early-stage heart failure. He has previously published on relevant policy issues including the financial incentives of bundled payments for heart failure disease management programs and the impact of composite scores on evaluating quality of care.

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