Compliance analysis of new oral anticoagulants in elderly patients with nonvalvular atrial fibrillation

doi:10.11958/20250024

Abstract

Abstract:

Objective To explore the influencing factors of compliance with new oral anticoagulants (NOACs) in elderly patients with nonvalvular atrial fibrillation (NVAF) and its correlation with social support. Methods The clinical data of 126 patients with NVAF treated by NOACs in Lu 'an People's Hospital of Anhui Province from January 2022 to January 2024 were selected by convenient sampling method. General data of patients were collected. According to Morisky medication compliance scale, patients were divided into two groups: the good compliance group (n=74) and the poor compliance group (n=52). Social support was investigated by Social Support Rating Scale (SSRS). General data of patients were compared between the good compliance group and the poor compliance group. The relationship between medication compliance and social support was analyzed by Pearson correlation. Multivariate Logistic regression was used to analyze the influencing factors of patient medication compliance. Results There were statistically significant differences in educational level, the proportion of patients with anxiety and depression, CHA₂DS₂-VASc score, HAS-BLED score and SSRS score between the good compliance group and the poor compliance group (P<0.05). The results of the correlation analysis showed that the medication compliance of patients was positively correlated with objective support (r=0.461), subjective support (r=0.432), support utilization (r=0.323) and SSRS score (r=0.596, P<0.05). The results of multivariate Logistic regression analysis showed that low educational level, accompanied by anxiety, low HAS-BLED and SSRS scores were risk factors for poor medication compliance in elderly NVAF patients (P<0.05). Conclusion Improving the social support level of elderly patients with NVAF is conducive to the formation of good medication compliance.

Key words: atrial fibrillation, Warfarin, medication adherence, social support, aged

CLC Number:

R541.75

Figures/Tables 3

References 24

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组别		n	性别（男/女）	年龄/岁		受教育程度（初中及以下/高中及中专/大专及以上）			职业（职工/农民）		医疗费用支付方式（全部报销或部分报销/全部自费）		合并症（高血压/ 糖尿病/冠心病）
依从性良好组		74	48/26	76.31±5.29		34/29/11			25/49		62/12		33/27/14
依从性较差组		52	30/22	76.54±5.62		37/7/8			18/34		43/9		21/23/8
χ²或t			0.666	0.232		10.524^＊			0.009		0.026		0.806
组别	药物类型（直接凝血酶抑制剂/Xa因子抑制剂）				焦虑（是/否）		抑郁（是/否）	住院次数/次		CHA₂DS₂-VASc 评分/分		HAS-BLED 评分/分		SSRS评分/分
依从性良好组	33/41				32/42		24/50	2.47±0.82		3.57±1.26		3.73±1.14		38.24±9.21
依从性较差组	24/28				36/16		32/20	2.37±0.74		2.87±0.92		2.97±0.85		31.27±8.45
χ²或t	0.030				8.302^＊		10.478^＊	0.757		3.411^＊＊		4.069^＊＊		4.323^＊＊

组别		n	性别（男/女）	年龄/岁		受教育程度（初中及以下/高中及中专/大专及以上）			职业（职工/农民）		医疗费用支付方式（全部报销或部分报销/全部自费）		合并症（高血压/ 糖尿病/冠心病）
依从性良好组		74	48/26	76.31±5.29		34/29/11			25/49		62/12		33/27/14
依从性较差组		52	30/22	76.54±5.62		37/7/8			18/34		43/9		21/23/8
χ²或t			0.666	0.232		10.524^＊			0.009		0.026		0.806
组别	药物类型（直接凝血酶抑制剂/Xa因子抑制剂）				焦虑（是/否）		抑郁（是/否）	住院次数/次		CHA₂DS₂-VASc 评分/分		HAS-BLED 评分/分		SSRS评分/分
依从性良好组	33/41				32/42		24/50	2.47±0.82		3.57±1.26		3.73±1.14		38.24±9.21
依从性较差组	24/28				36/16		32/20	2.37±0.74		2.87±0.92		2.97±0.85		31.27±8.45
χ²或t	0.030				8.302^＊		10.478^＊	0.757		3.411^＊＊		4.069^＊＊		4.323^＊＊

因素	β	SE	Wald χ²	P	OR（95%CI）
受教育程度	1.048	0.441	5.650	0.017	2.853（1.202~6.770）
伴焦虑情绪	1.145	0.442	6.703	0.010	3.142（1.321~7.475）
伴抑郁情绪	0.378	0.438	0.746	0.388	1.460（0.619~3.444）
CHA₂DS₂-VASc评分	-0.019	0.255	0.006	0.939	0.981（0.596~1.615）
HAS-BLED评分	-0.530	0.254	4.359	0.037	0.589（0.358~0.968）
SSRS评分	-0.067	0.030	5.020	0.025	0.935（0.881~0.992）
常数项	2.303	1.043	4.878	0.027	10.003

因素	β	SE	Wald χ²	P	OR（95%CI）
受教育程度	1.048	0.441	5.650	0.017	2.853（1.202~6.770）
伴焦虑情绪	1.145	0.442	6.703	0.010	3.142（1.321~7.475）
伴抑郁情绪	0.378	0.438	0.746	0.388	1.460（0.619~3.444）
CHA₂DS₂-VASc评分	-0.019	0.255	0.006	0.939	0.981（0.596~1.615）
HAS-BLED评分	-0.530	0.254	4.359	0.037	0.589（0.358~0.968）
SSRS评分	-0.067	0.030	5.020	0.025	0.935（0.881~0.992）
常数项	2.303	1.043	4.878	0.027	10.003