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This manuscript reviews the impact of once\u2010daily (OD) <jats:italic>vs<\/jats:italic> twice\u2010daily (BID) dosing regimens on adherence and persistence to the authorized DOACs (dabigatran, rivaroxaban, apixaban and edoxaban) in patients with NVAF, aiming to provide insights into guide clinical decision\u2010making.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A systematic review was performed. First, a bibliographical search was carried out in PubMed, Scopus and the Cochrane Library. Articles that provided quantitative data comparing adherence and\/or persistence associated with OD <jats:italic>vs<\/jats:italic> BID regimens of DOACs among patients receiving treatment for NVAF were included. Two analyses of adherence and persistence were conducted, one based on the overall outcomes and another, more restricted, to minimize the risk of overestimating results. Additionally, univariate analyses were conducted based on the number of follow\u2010up days and the DOAC molecule.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Thirty\u2010nine studies, involving 976\u2009494 patients, were analysed. The OD regimen demonstrated significantly higher adherence and persistence (<jats:italic>P<\/jats:italic>\u00a0&lt;\u2009.05) than the BID regimen in most outcomes. Adherence favoured OD in 53.1% of cases, while only 12.2% favoured BID. Similarly, persistence was higher with the OD regimen in 67.7% of cases compared to 14.9% for the BID regimen. These results remained consistent over time; nevertheless, variations were observed depending on the specific DOAC molecules.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Adherence and persistence of treatment with DOACs in patients with NVAF were greater for the OD than for the BID regimen.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bcp.70003","type":"journal-article","created":{"date-parts":[[2025,2,17]],"date-time":"2025-02-17T05:35:24Z","timestamp":1739770524000},"page":"1096-1113","source":"Crossref","is-referenced-by-count":18,"title":["Adherence and persistence with direct oral anticoagulants by dose regimen: A systematic review"],"prefix":"10.1002","volume":"91","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2802-2477","authenticated-orcid":false,"given":"Ra\u00fal","family":"Quir\u00f3s L\u00f3pez","sequence":"first","affiliation":[{"name":"Network for Research in Chronicity, Primary Care, and Health Prevention and Promotion Costa del Sol University Hospital  Marbella Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesc","family":"Formiga P\u00e9rez","sequence":"additional","affiliation":[{"name":"Geriatric Unit, Internal Medicine Department Hospital Universitari de Bellvitge, Systemic Diseases and Ageing Group, Cardiovascular, Respiratory  Barcelona Spain"},{"name":"Systemic Diseases and Cellular Aging Program, Institut d'Investigaci\u00f3 Biom\u00e8dica de Bellvitge L'Hospitalet de Llobregat  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jan","family":"Beyer\u2010Westendorf","sequence":"additional","affiliation":[{"name":"Department of Medicine I, Division of Thrombosis &amp; Hemostasis University Hospital \u201cCarl Gustac Carus\u201d  Dresden Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,2,16]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2021.654620"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000659"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCRESAHA.117.309732"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005119"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.2217\/fca-2021-0120"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_2_10_8_1","volume-title":"Atrial fibrillation: diagnosis and management. 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