Structured pharmaceutical interviews enhance knowledge and medication adherence in DOAC therapy: Insights from the EDUC-AOD study.

Abstract

Direct oral anticoagulants (DOACs) are first-line therapies for atrial fibrillation and venous thromboembolism. Structured pharmaceutical interviews (SPIs) aim to enhance patient knowledge of DOAC therapy, thereby improving medication adherence and reducing both disease-related and treatment-related complications. The EDUC-AOD study was conducted to assess the impact of SPIs on patient knowledge, medication adherence, and clinical complications. Patients newly prescribed DOACs were enrolled from two centers, with only one center delivering SPIs. The primary objective was to evaluate the impact of SPIs on patients' knowledge and medication adherence at 3 months, using standardized questionnaires. Secondary objectives included evaluating the impact of SPIs on clinical complications, as well as knowledge and medication adherence at 6 months. Multivariate logistic regression analysis, adjusted for propensity score, was used to identify predictors of improved knowledge and adherence. From January 2021 to June 2023, 145 patients were enrolled: 68 in the intervention group and 77 in the control group. At 3 months, the intervention group demonstrated significantly higher rates of satisfactory knowledge (74 % vs. 12 %, p < 0.001) and good medication adherence (86 % vs. 64 %, p = 0.008). SPIs were significant predictors of satisfactory knowledge (OR = 23.6, 95 % CI [8.3-81.1], p < 0.001) and good medication adherence (OR = 3.5, 95 % CI [1.4-10.0], p = 0.012). Treatment indication (OR = 4.9, 95 % CI [1.7-16.3], p = 0.005) and lower HAS-BLED score (OR = 0.4, 95 % CI [0.1-1.0], p = 0.039) were also associated with improved outcomes. At 6 months, the intervention group experienced significantly fewer clinical complications (0 vs. 9, p = 0.010). SPIs substantially enhance patients' knowledge and adherence to DOAC therapy and reduce clinical complications. Integrating SPIs into routine care may optimize anticoagulant management. Further randomized trials are needed to confirm these findings.