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International Journal of Behavioral Medicine
Published in: International Journal of Behavioral Medicine 1/2010

01-03-2010

Patient Attitudinal and Behavioral Factors Associated with Warfarin Non-adherence at Outpatient Anticoagulation Clinics

Authors: Dean G. Cruess, A. Russell Localio, Alec B. Platt, Colleen M. Brensinger, Jason D. Christie, Robert Gross, Catherine S. Parker, Maureen Price, Joshua P. Metlay, Abigail Cohen, Craig W. Newcomb, Brian L. Strom, Stephen E. Kimmel

Published in: International Journal of Behavioral Medicine | Issue 1/2010

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Abstract

Background

Warfarin is an anticoagulant effective in preventing stroke, but it has a narrow therapeutic range requiring optimal adherence to achieve the most favorable effects.

Purpose

The goal of this study was to examine specific patient factors that might help explain warfarin non-adherence at outpatient anticoagulation clinics.

Method

In a prospective cohort study of 156 adults, we utilized logistic regression analyses to examine the relationship between the five Treatment Prognostics scales from the Millon Behavioral Medicine Diagnostic (MBMD), as well as three additional MBMD scales (Depression, Future Pessimism, and Social Isolation), and daily warfarin non-adherence assessed using electronic medication event monitoring systems caps over a median of 139 days.

Results

Four of the five Treatment Prognostic scales and greater social isolation were associated with warfarin non-adherence. When controlling for pertinent demographic and medical variables, the Information Discomfort scale remained significantly associated with warfarin non-adherence over time.

Conclusion

Although several factors were related to warfarin non-adherence, patients reporting a lack of receptivity to details regarding their medical illness seemed most at risk for warfarin non-adherence. This information might aid in the development of interventions to enhance warfarin adherence and perhaps reduce adverse medical events.
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Metadata
Title
Patient Attitudinal and Behavioral Factors Associated with Warfarin Non-adherence at Outpatient Anticoagulation Clinics
Authors
Dean G. Cruess
A. Russell Localio
Alec B. Platt
Colleen M. Brensinger
Jason D. Christie
Robert Gross
Catherine S. Parker
Maureen Price
Joshua P. Metlay
Abigail Cohen
Craig W. Newcomb
Brian L. Strom
Stephen E. Kimmel
Publication date
01-03-2010
Publisher
Springer US
Published in
International Journal of Behavioral Medicine / Issue 1/2010
Print ISSN: 1070-5503
Electronic ISSN: 1532-7558
DOI
https://doi.org/10.1007/s12529-009-9052-6

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