{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:35:05Z","timestamp":1792787705668,"version":"4.5.0"},"reference-count":23,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"name":"Clinical Pharmacy Special Committee of Zhejiang Medical Doctor Association","award":["YS2024-3-019"],"award-info":[{"award-number":["YS2024-3-019"]}]},{"name":"Clinical Medicine Special Fund Project of Zhejiang Medical Association","award":["2023ZYC-A08"],"award-info":[{"award-number":["2023ZYC-A08"]}],"id":[{"id":"https:\/\/ror.org\/00kv1td69","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Cardiovasc Pharmacol Ther"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To investigate adherence to four direct oral anticoagulants (DOACs) and its influencing factors in patients with non-valvular atrial fibrillation (NVAF), providing evidence for strategies to improve adherence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study included NVAF patients initiating DOAC therapy at a tertiary hospital (January 2016\u2013November 2023). Adherence was evaluated using the proportion of days covered (PDC), with PDC \u2265 0.8 defined as good adherence. Adherence levels for dabigatran, rivaroxaban, apixaban, and edoxaban were compared at 3, 6, 9, and 12 months. Logistic regression identified factors influencing 1-year adherence, assessing the impact of initiation year and the National Volume-Based Drug Procurement (NVBP) policy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 1,150 NVAF patients were enrolled (dabigatran: n = 401; rivaroxaban: n = 656; apixaban: n = 18; edoxaban: n = 75),In this main cohort, overall adherence progressively declined, with only 40.78% achieving PDC \u2265 0.8 at 1 year. Significant differences existed among groups (P&lt;0.001). Dabigatran demonstrated the highest 1-year adherence (53.62%), followed by rivaroxaban (34.91%), apixaban (27.78%), and edoxaban (26.67%). Compared with dabigatran, rivaroxaban (OR=0.47) and edoxaban (OR=0.33) were independently associated with poorer adherence. Age \u226575 years (OR=0.62) and self-pay (OR=0.49) were risk factors for poor adherence, while diabetes (OR=1.48) and prior stroke (OR=1.48) predicted better adherence. Patients initiating therapy in 2017 showed the highest adherence. Post-NVBP, generic dabigatran adherence exceeded the original formulation at 6 months (P=0.038), but this difference disappeared at 1 and 2 years.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DOAC adherence among NVAF patients is suboptimal and decreases over time. Among the four DOACs, dabigatran was associated with the highest adherence. Elderly (\u226575 years) and self-paying patients are at higher risk of poor adherence, whereas those with diabetes or stroke history show better adherence. The NVBP policy improves adherence short-term, but long-term effects are limited. Targeted interventions are necessary for high-risk populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10742484261490639","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T20:35:15Z","timestamp":1790195715000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Adherence to Direct Oral Anticoagulants in Patients With Non-valvular Atrial Fibrillation: A Single-Center Retrospective Study"],"prefix":"10.1177","volume":"31","author":[{"given":"Cuie","family":"Chang","sequence":"first","affiliation":[{"name":"Zhejiang University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sha","family":"Lv","sequence":"additional","affiliation":[{"name":"Zhejiang Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingyan","family":"Yu","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lingcheng","family":"Xu","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donghang","family":"Xu","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibin","family":"Dai","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0687-8100","authenticated-orcid":false,"given":"Junjun","family":"Xu","sequence":"additional","affiliation":[{"name":"Zhejiang University School of Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"issue":"2","key":"e_1_3_5_2_2","first-page":"103","article-title":"Geriatric Medicine Branch, Chinese Medical Association; Cardiovascular Disease Branch, Chinese Association of Geriatric Research. Chinese expert consensus on the diagnosis and management of atrial fibrillation in the elderly","volume":"28","author":"Group C","year":"2024","unstructured":"Group C. Geriatric Medicine Branch, Chinese Medical Association; Cardiovascular Disease Branch, Chinese Association of Geriatric Research. Chinese expert consensus on the diagnosis and management of atrial fibrillation in the elderly. Chinese Journal of Cardiac Arrhythmias. 2024;28(2):103-124.","journal-title":"Chinese Journal of Cardiac Arrhythmias"},{"issue":"5","key":"e_1_3_5_3_2","first-page":"540","article-title":"Analysis of factors influencing adherence to novel oral anticoagulants in elderly patients with non-valvular atrial fibrillation","volume":"12","author":"Qiao J","year":"2020","unstructured":"Qiao J, Bai YY, Ma JL, et al. Analysis of factors influencing adherence to novel oral anticoagulants in elderly patients with non-valvular atrial fibrillation. Chinese Journal of Evidence-Based Cardiovascular Medicine. 2020;12(5):540-542.","journal-title":"Chinese Journal of Evidence-Based Cardiovascular Medicine"},{"key":"e_1_3_5_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euae043"},{"key":"e_1_3_5_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euz273"},{"key":"e_1_3_5_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ehjcvp\/pvaa017"},{"key":"e_1_3_5_7_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0341633"},{"key":"e_1_3_5_8_2","doi-asserted-by":"publisher","DOI":"10.1136\/heartjnl-2019-315307"},{"key":"e_1_3_5_9_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00228-015-1983-z"},{"key":"e_1_3_5_10_2","doi-asserted-by":"publisher","DOI":"10.1111\/jth.12845"},{"key":"e_1_3_5_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-031342"},{"key":"e_1_3_5_12_2","volume-title":"Opinions of the General Office of the State Council on Promoting the Regular and Institutionalized Implementation of Centralized Drug Volume-Based Procurement (Guo Ban Fa [2021] No. 2)","author":"General Office of the State Council of the People's Republic of China","year":"2021","unstructured":"General Office of the State Council of the People's Republic of China. Opinions of the General Office of the State Council on Promoting the Regular and Institutionalized Implementation of Centralized Drug Volume-Based Procurement (Guo Ban Fa [2021] No. 2); 2021."},{"key":"e_1_3_5_13_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaa612"},{"key":"e_1_3_5_14_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2014.03.023"},{"key":"e_1_3_5_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.115.003074"},{"key":"e_1_3_5_16_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-025-96030-6"},{"key":"e_1_3_5_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/europace\/euab091"},{"key":"e_1_3_5_18_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-034778"},{"key":"e_1_3_5_19_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.119.005969"},{"key":"e_1_3_5_20_2","doi-asserted-by":"publisher","DOI":"10.1002\/pds.5242"},{"key":"e_1_3_5_21_2","doi-asserted-by":"publisher","DOI":"10.2147\/PPA.S463164"},{"key":"e_1_3_5_22_2","doi-asserted-by":"publisher","DOI":"10.1002\/bcp.70003"},{"key":"e_1_3_5_23_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11239-023-02921-8"},{"key":"e_1_3_5_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2025.109423"}],"container-title":["Journal of Cardiovascular Pharmacology and Therapeutics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10742484261490639","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/10742484261490639","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/10742484261490639","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T08:21:29Z","timestamp":1790497289000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/10742484261490639"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":23,"alternative-id":["10.1177\/10742484261490639"],"URL":"https:\/\/doi.org\/10.1177\/10742484261490639","relation":{},"ISSN":["1074-2484","1940-4034"],"issn-type":[{"value":"1074-2484","type":"print"},{"value":"1940-4034","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]},"article-number":"10742484261490639"}}