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Screening tool ‘predicts warfarin non-adherence’



By Emma Wilkinson

A simple screening tool could help identify patients at risk for non-adherence to warfarin therapy, say US researchers.

In a study of 114 patients attending an anticoagulation clinic, participants were given a pill bottle with an electronic cap to monitor opening on a daily basis.

Researchers discovered that patients failed to open their pills every day or failed to follow instructions 21.3% of the time.

They then identified nine factors – educational attainment, employment status, history of hypertension, use of warfarin for stroke or transient ischemic attack, previous use of warfarin, cognitive functioning, baseline general health, and Short-Form-36 mental component score – to create a tool to predict who would struggle with adherence.

Median non-adherence was 5.8% in patients with four or fewer points on the scoring system, compared with 9.1% for those with five points, 14.5% for six points, 14.7% for seven points, and 29.3% for eight or more points.

The researchers from the University of Pennsylvania said the tool would a useful addition to ‘simple INR monitoring and patient assessment’ to focus efforts ‘on those at higher risk for non-adherence’.

Chest 2010;137:88389

A simple screening tool could help identify patients at risk for non-adherence to warfarin therapy, according to US researchers. A simple screening tool could help identify patients at risk for non-adherence to warfarin therapy, according to US researchers.