Adherence to oral anticoagulant therapy in patients with atrial fibrillation: focus on non-vitamin K antagonist oral anticoagulants

Research output: Contribution to journalArticlepeer-review


  • Valeria Raparelli
  • Marco Proietti
  • Roberto Cangemi
  • Basili Stefania

Colleges, School and Institutes

External organisations

  • University of Rome 'La Sapienza'


Oral anticoagulation is pivotal in the management of thromboembolic risk in non-valvular atrial fibrillation (NVAF) patients. Effective anticoagulation is important to avoid major adverse events and medication adherence is central to achieve good anticoagulation control. Non-vitamin K antagonist oral anticoagulants (NOACs) are as effective and safe as vitamin K antagonist (VKAs) in NVAF patients. Due to the absence of routine anticoagulation monitoring
with NOACs treatment, concerns have been raised about patient’s adherence to NOACs and reallife data demonstrates variability in adherence and persistence. A multi-level approach, including patients’ preferences, factors determining physicians’ prescribing habits and healthcare system infrastructure and support, is warranted to improve initiation and adherence of anticoagulants.
Adherence to NOACs is paramount to achieve a clinical benefit. Implementation of educational programs and easy-to-use tools to identify patients most likely to be non-adherent to NOACs, are central issues in improving the quality of NVAF anticoagulation management.


Original languageEnglish
Pages (from-to)209-218
JournalThrombosis and Haemostasis
Issue number2
Early online date10 Nov 2016
Publication statusPublished - 2017


  • atrial fibrillation, oral anticoagulation, non-vitamin K antagonist oral anticoagulants, adherence, persistence