{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T19:47:43Z","timestamp":1788896863675,"version":"build-2803163510"},"reference-count":31,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T00:00:00Z","timestamp":1753920000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100004587","name":"Instituto de Salud Carlos III","doi-asserted-by":"publisher","award":["RD21\/0016\/0006"],"award-info":[{"award-number":["RD21\/0016\/0006"]}],"id":[{"id":"10.13039\/501100004587","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to identify adherence trajectories and associated factors in atrial fibrillation patients who initiated direct oral anticoagulant (DOAC) therapy, using population-based data from the Catalonia and Valencia regions in Spain during a 2-year follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>Group-based trajectory modelling (GBTM) was applied to assess adherence patterns in cohorts comprising 14,641 patients in Catalonia and 13,211 in Valencia. Adherence trajectories were categorised based on prescription data, revealing three main trajectories in Valencia and five in Catalonia. Most patients in Valencia demonstrated high adherence, whereas Catalonia showed more varied patterns, including early, gradual, and late declines. Factors associated with non-adherence included high co-insurance levels, alcohol use, and specific DOACs, such as dabigatran.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Adherence trajectories differed between the two regions, with three identified in Valencia and five in Catalonia. Shared non-adherence patterns were observed across both cohorts, while Catalonia exhibited additional noncompliance trends. Key factors associated with non-adherence included socio-economic variables, clinical characteristics, and the type of DOAC prescribed. Understanding these patterns is essential for developing targeted intervention strategies to improve adherence and optimise treatment outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fphar.2025.1562620","type":"journal-article","created":{"date-parts":[[2025,7,31]],"date-time":"2025-07-31T05:38:39Z","timestamp":1753940319000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Real-world adherence trajectories to direct oral anticoagulants in naive patients with atrial fibrillation in Spain"],"prefix":"10.3389","volume":"16","author":[{"given":"L. M.","family":"Legu\u00edzamo-Mart\u00ednez","sequence":"first","affiliation":[{"name":"Department of Clinical Pharmacology, Area Medicament, Hospital Clinic of Barcelona","place":["Barcelona, Spain"]},{"name":"Department of Clinical Pharmacology, Institut d\u2019Investigacions Biom\u00e8diques August Pi i Sunyer (IDIBAPS)","place":["Barcelona, Spain"]},{"name":"Department of Pharmacology, Therapeutics and Toxicology, Universitat Aut\u00f2noma de Barcelona (UAB)","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. E.","family":"Ballarin","sequence":"additional","affiliation":[{"name":"Clinical Pharmacology Service, Vall d\u2019Hebron Hospital Universitari, Vall Hebron Institut de Recerca (VHIR)","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I.","family":"Hurtado","sequence":"additional","affiliation":[{"name":"Health Services Research and Pharmacoepidemiology Unit, Fundacio per al Foment de la Investigacio Sanitaria i Biomedica (FISABIO)","place":["Valencia, Spain"]},{"name":"Red de Investigaci\u00f3n en Cronicidad, Atenci\u00f3n Primaria y Prevenci\u00f3n y Promoci\u00f3n de la Salud - RICAPPS","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"Sanf\u00e9lix-Gimeno","sequence":"additional","affiliation":[{"name":"Health Services Research and Pharmacoepidemiology Unit, Fundacio per al Foment de la Investigacio Sanitaria i Biomedica (FISABIO)","place":["Valencia, Spain"]},{"name":"Red de Investigaci\u00f3n en Cronicidad, Atenci\u00f3n Primaria y Prevenci\u00f3n y Promoci\u00f3n de la Salud - RICAPPS","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"F.","family":"S\u00e1nchez-S\u00e1ez","sequence":"additional","affiliation":[{"name":"Health Services Research and Pharmacoepidemiology Unit, Fundacio per al Foment de la Investigacio Sanitaria i Biomedica (FISABIO)","place":["Valencia, Spain"]},{"name":"Red de Investigaci\u00f3n en Cronicidad, Atenci\u00f3n Primaria y Prevenci\u00f3n y Promoci\u00f3n de la Salud - RICAPPS","place":["Barcelona, Spain"]},{"name":"Department of Applied Statistics and Operational Research, and Quality, Universitat Polit\u00e8cnica de Val\u00e8ncia","place":["Valencia, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.","family":"Sabat\u00e9","sequence":"additional","affiliation":[{"name":"Department of Pharmacology, Therapeutics and Toxicology, Universitat Aut\u00f2noma de Barcelona (UAB)","place":["Barcelona, Spain"]},{"name":"Clinical Pharmacology Service, Vall d\u2019Hebron Hospital Universitari, Vall Hebron Institut de Recerca (VHIR)","place":["Barcelona, Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,7,31]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.ijcard.2016.03.212","article-title":"Association between once- and twice-daily direct oral anticoagulant adherence in nonvalvular atrial fibrillation patients and rates of ischemic stroke","volume":"215","author":"Alberts","year":"2016","journal-title":"Int. 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