Adherence to rivaroxaban for the treatment of venous thromboembolism – Results from the FIRST Registry

Vicky Speed; Vivian Auyeung; Jignesh Patel; Derek Cooper; S Miller; Lara Roberts; Rajesh Patel; Roopen Arya

doi:10.1002/rth2.12614

Adherence to rivaroxaban for the treatment of venous thromboembolism – Results from the FIRST Registry

Vicky Speed^*, Vivian Auyeung, Jignesh Patel, Derek Cooper, S Miller, Lara Roberts, Rajesh Patel, Roopen Arya

^*Corresponding author for this work

Institute of Pharmaceutical Science

Research output: Contribution to journal › Article › peer-review

5 Citations (Scopus)

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Abstract

Background: Medication nonadherence can result in poor clinical outcomes and significant costs to health care providers. When treating venous thromboembolism (VTE), subtherapeutic anticoagulation may contribute to complications such as recurrent VTE or postthrombotic syndrome. Objectives: To describe the extent, reasons for, and predictors of nonadherence to rivaroxaban for the treatment of VTE in clinical practice in the United Kingdom reported by participants of the FIRST registry. Patients/Methods: The FIRST registry was an observational, multicenter registry reporting on the use of rivaroxaban in routine clinical practice. FIRST registry participants completed an adherence screening questionnaire during their treatment and follow-up. Results: In total, 1028 participants completed 1660 questionnaires over 2 years. One hundred thirteen of 1028 (11%) reported nonadherence at 28 days (interquartile range, 21-45). Reasons given for nonadherence at 1 month were forgetfulness (8.6% vs 74.7%; P <.001), carelessness (2.7% vs 27.3%; P <.001) or a change in routine (7.4% vs 25.5%; P <.001) reported by adherent and nonadherent participants, respectively. Older age (10-year increments) was the strongest predictor of good adherence (adjusted odds ratio, 1.21; 95% confidence interval, 1.06-1.39; 1 = adherent). Conclusions: Overall adherence to rivaroxaban was high, and most nonadherence was unintentional. Identification of those at risk of nonadherence may reduce the risk of VTE recurrence and long-term complications.

Original language	English
Article number	e12614
Number of pages	11
Journal	Research and practice in thrombosis and haemostasis
Volume	5
Issue number	8
Early online date	21 Nov 2021
DOIs	https://doi.org/10.1002/rth2.12614
Publication status	Published - Dec 2021

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10.1002/rth2.12614Licence: CC BY-NC-ND

Speed Auyeung Patel Cooper Miller Roberts Patel Arya. Adherence to rivaroxaban for the treatment of venous thromboembolism - results from the FIRST registry. RPTH (2021)Final published version, 1.14 MBLicence: CC BY-NC-ND

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@article{d7dbf6b1f9b64e3eadb04dc2b66252f7,

title = "Adherence to rivaroxaban for the treatment of venous thromboembolism – Results from the FIRST Registry",

abstract = "Background: Medication nonadherence can result in poor clinical outcomes and significant costs to health care providers. When treating venous thromboembolism (VTE), subtherapeutic anticoagulation may contribute to complications such as recurrent VTE or postthrombotic syndrome. Objectives: To describe the extent, reasons for, and predictors of nonadherence to rivaroxaban for the treatment of VTE in clinical practice in the United Kingdom reported by participants of the FIRST registry. Patients/Methods: The FIRST registry was an observational, multicenter registry reporting on the use of rivaroxaban in routine clinical practice. FIRST registry participants completed an adherence screening questionnaire during their treatment and follow-up. Results: In total, 1028 participants completed 1660 questionnaires over 2 years. One hundred thirteen of 1028 (11%) reported nonadherence at 28 days (interquartile range, 21-45). Reasons given for nonadherence at 1 month were forgetfulness (8.6% vs 74.7%; P <.001), carelessness (2.7% vs 27.3%; P <.001) or a change in routine (7.4% vs 25.5%; P <.001) reported by adherent and nonadherent participants, respectively. Older age (10-year increments) was the strongest predictor of good adherence (adjusted odds ratio, 1.21; 95% confidence interval, 1.06-1.39; 1 = adherent). Conclusions: Overall adherence to rivaroxaban was high, and most nonadherence was unintentional. Identification of those at risk of nonadherence may reduce the risk of VTE recurrence and long-term complications.",

author = "Vicky Speed and Vivian Auyeung and Jignesh Patel and Derek Cooper and S Miller and Lara Roberts and Rajesh Patel and Roopen Arya",

note = "Funding Information: The FIRST registry was funded by an investigator-initiated research grant from Bayer PLC. The FIRST registry principal investigators were Basildon and Thurrock University Hospitals NHS Foundation Trust ? K. Thomas; Basingstoke and North Hampshire Hospital ? T. Everington; Bournemouth Hospitals NHS Foundation Trust ? J. Mainwaring; Royal Devon and Exeter NHS Foundation Trust ? A. Sharp and A. Renouf; The Dudley Group NHS Foundation Trust ? S. Jenkins; Epsom and St. Helier University Hospitals ? S. Mutgi and C. De Lord; St. Georges University Hospitals NHS Foundation Trust ? J. Uprichard; The Hillingdon Hospitals NHS Foundation Trust ? M. Pasha; Heartlands Hospital ? C. Kartsios; King?s College Hospital ? R. Arya; University Hospitals of Leicester ? B. Myers; University Hospital Lewisham ? K. Thanigaikumar; United Lincolnshire Hospitals?B. Myers; Maidstone and Tunbridge Wells NHS Trust ? C. Wykes; Newcastle upon Tyne Hospitals NHS Foundation Trust ? T. Biss; Poole Hospital NHS Foundation Trust ? C. Prescott; Portsmouth Hospitals NHS Foundation Trust ? A. Chauhan; Barking, Havering and Redbridge University Hospital?K. Saja; Salisbury NHS Foundation Trust ? T. Everington and J. Cullis. The authors thank all physicians, certified research nurses, and hospitals that supported the FIRST registry and all participants from across the United Kingdom for their contribution to the study. Funding Information: The FIRST registry was funded by an investigator‐initiated research grant from Bayer PLC. The FIRST registry principal investigators were Basildon and Thurrock University Hospitals NHS Foundation Trust – K. Thomas; Basingstoke and North Hampshire Hospital – T. Everington; Bournemouth Hospitals NHS Foundation Trust – J. Mainwaring; Royal Devon and Exeter NHS Foundation Trust – A. Sharp and A. Renouf; The Dudley Group NHS Foundation Trust – S. Jenkins; Epsom and St. Helier University Hospitals – S. Mutgi and C. De Lord; St. Georges University Hospitals NHS Foundation Trust – J. Uprichard; The Hillingdon Hospitals NHS Foundation Trust – M. Pasha; Heartlands Hospital – C. Kartsios; King{\textquoteright}s College Hospital – R. Arya; University Hospitals of Leicester – B. Myers; University Hospital Lewisham – K. Thanigaikumar; United Lincolnshire Hospitals–B. Myers; Maidstone and Tunbridge Wells NHS Trust – C. Wykes; Newcastle upon Tyne Hospitals NHS Foundation Trust – T. Biss; Poole Hospital NHS Foundation Trust – C. Prescott; Portsmouth Hospitals NHS Foundation Trust – A. Chauhan; Barking, Havering and Redbridge University Hospital–K. Saja; Salisbury NHS Foundation Trust – T. Everington and J. Cullis. The authors thank all physicians, certified research nurses, and hospitals that supported the FIRST registry and all participants from across the United Kingdom for their contribution to the study. Publisher Copyright: {\textcopyright} 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).",

year = "2021",

month = dec,

doi = "10.1002/rth2.12614",

language = "English",

volume = "5",

journal = "Research and practice in thrombosis and haemostasis",

issn = "2475-0379",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "8",

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TY - JOUR

T1 - Adherence to rivaroxaban for the treatment of venous thromboembolism – Results from the FIRST Registry

AU - Speed, Vicky

AU - Auyeung, Vivian

AU - Patel, Jignesh

AU - Cooper, Derek

AU - Miller, S

AU - Roberts, Lara

AU - Patel, Rajesh

AU - Arya, Roopen

N1 - Funding Information: The FIRST registry was funded by an investigator-initiated research grant from Bayer PLC. The FIRST registry principal investigators were Basildon and Thurrock University Hospitals NHS Foundation Trust ? K. Thomas; Basingstoke and North Hampshire Hospital ? T. Everington; Bournemouth Hospitals NHS Foundation Trust ? J. Mainwaring; Royal Devon and Exeter NHS Foundation Trust ? A. Sharp and A. Renouf; The Dudley Group NHS Foundation Trust ? S. Jenkins; Epsom and St. Helier University Hospitals ? S. Mutgi and C. De Lord; St. Georges University Hospitals NHS Foundation Trust ? J. Uprichard; The Hillingdon Hospitals NHS Foundation Trust ? M. Pasha; Heartlands Hospital ? C. Kartsios; King?s College Hospital ? R. Arya; University Hospitals of Leicester ? B. Myers; University Hospital Lewisham ? K. Thanigaikumar; United Lincolnshire Hospitals?B. Myers; Maidstone and Tunbridge Wells NHS Trust ? C. Wykes; Newcastle upon Tyne Hospitals NHS Foundation Trust ? T. Biss; Poole Hospital NHS Foundation Trust ? C. Prescott; Portsmouth Hospitals NHS Foundation Trust ? A. Chauhan; Barking, Havering and Redbridge University Hospital?K. Saja; Salisbury NHS Foundation Trust ? T. Everington and J. Cullis. The authors thank all physicians, certified research nurses, and hospitals that supported the FIRST registry and all participants from across the United Kingdom for their contribution to the study. Funding Information: The FIRST registry was funded by an investigator‐initiated research grant from Bayer PLC. The FIRST registry principal investigators were Basildon and Thurrock University Hospitals NHS Foundation Trust – K. Thomas; Basingstoke and North Hampshire Hospital – T. Everington; Bournemouth Hospitals NHS Foundation Trust – J. Mainwaring; Royal Devon and Exeter NHS Foundation Trust – A. Sharp and A. Renouf; The Dudley Group NHS Foundation Trust – S. Jenkins; Epsom and St. Helier University Hospitals – S. Mutgi and C. De Lord; St. Georges University Hospitals NHS Foundation Trust – J. Uprichard; The Hillingdon Hospitals NHS Foundation Trust – M. Pasha; Heartlands Hospital – C. Kartsios; King’s College Hospital – R. Arya; University Hospitals of Leicester – B. Myers; University Hospital Lewisham – K. Thanigaikumar; United Lincolnshire Hospitals–B. Myers; Maidstone and Tunbridge Wells NHS Trust – C. Wykes; Newcastle upon Tyne Hospitals NHS Foundation Trust – T. Biss; Poole Hospital NHS Foundation Trust – C. Prescott; Portsmouth Hospitals NHS Foundation Trust – A. Chauhan; Barking, Havering and Redbridge University Hospital–K. Saja; Salisbury NHS Foundation Trust – T. Everington and J. Cullis. The authors thank all physicians, certified research nurses, and hospitals that supported the FIRST registry and all participants from across the United Kingdom for their contribution to the study. Publisher Copyright: © 2021 The Authors. Research and Practice in Thrombosis and Haemostasis published by Wiley Periodicals LLC on behalf of International Society on Thrombosis and Haemostasis (ISTH).

PY - 2021/12

Y1 - 2021/12

N2 - Background: Medication nonadherence can result in poor clinical outcomes and significant costs to health care providers. When treating venous thromboembolism (VTE), subtherapeutic anticoagulation may contribute to complications such as recurrent VTE or postthrombotic syndrome. Objectives: To describe the extent, reasons for, and predictors of nonadherence to rivaroxaban for the treatment of VTE in clinical practice in the United Kingdom reported by participants of the FIRST registry. Patients/Methods: The FIRST registry was an observational, multicenter registry reporting on the use of rivaroxaban in routine clinical practice. FIRST registry participants completed an adherence screening questionnaire during their treatment and follow-up. Results: In total, 1028 participants completed 1660 questionnaires over 2 years. One hundred thirteen of 1028 (11%) reported nonadherence at 28 days (interquartile range, 21-45). Reasons given for nonadherence at 1 month were forgetfulness (8.6% vs 74.7%; P <.001), carelessness (2.7% vs 27.3%; P <.001) or a change in routine (7.4% vs 25.5%; P <.001) reported by adherent and nonadherent participants, respectively. Older age (10-year increments) was the strongest predictor of good adherence (adjusted odds ratio, 1.21; 95% confidence interval, 1.06-1.39; 1 = adherent). Conclusions: Overall adherence to rivaroxaban was high, and most nonadherence was unintentional. Identification of those at risk of nonadherence may reduce the risk of VTE recurrence and long-term complications.

AB - Background: Medication nonadherence can result in poor clinical outcomes and significant costs to health care providers. When treating venous thromboembolism (VTE), subtherapeutic anticoagulation may contribute to complications such as recurrent VTE or postthrombotic syndrome. Objectives: To describe the extent, reasons for, and predictors of nonadherence to rivaroxaban for the treatment of VTE in clinical practice in the United Kingdom reported by participants of the FIRST registry. Patients/Methods: The FIRST registry was an observational, multicenter registry reporting on the use of rivaroxaban in routine clinical practice. FIRST registry participants completed an adherence screening questionnaire during their treatment and follow-up. Results: In total, 1028 participants completed 1660 questionnaires over 2 years. One hundred thirteen of 1028 (11%) reported nonadherence at 28 days (interquartile range, 21-45). Reasons given for nonadherence at 1 month were forgetfulness (8.6% vs 74.7%; P <.001), carelessness (2.7% vs 27.3%; P <.001) or a change in routine (7.4% vs 25.5%; P <.001) reported by adherent and nonadherent participants, respectively. Older age (10-year increments) was the strongest predictor of good adherence (adjusted odds ratio, 1.21; 95% confidence interval, 1.06-1.39; 1 = adherent). Conclusions: Overall adherence to rivaroxaban was high, and most nonadherence was unintentional. Identification of those at risk of nonadherence may reduce the risk of VTE recurrence and long-term complications.

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U2 - 10.1002/rth2.12614

DO - 10.1002/rth2.12614

M3 - Article

SN - 2475-0379

VL - 5

JO - Research and practice in thrombosis and haemostasis

JF - Research and practice in thrombosis and haemostasis

IS - 8

M1 - e12614

ER -

Adherence to rivaroxaban for the treatment of venous thromboembolism – Results from the FIRST Registry

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