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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/advagg_css\/css__ce2QY63WIanKyr8eSq7eavr1XQRRmFD6ZSmwpyJi8lM__zXwFqpqmxrZOXXcd_TpBQpjuELbmIP9wBR5UuTDWAO4__YJWWMMdfCJuAFm5cUEp88OsodhO3ZA-2lzRfoBsSlk4.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\u003Cp id=\u0022p-1\u0022\u003EIn the AEGEAN study, the addition of an education program to apixaban therapy in patients with atrial fibrillation did not improve patient adherence or persistence to therapy at 24 weeks. The rates of adherence and persistence were high.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Eatrial fibrillation\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eapixaban\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003ENOAC\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Eadherence\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Epersistence\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Ecardiology \u0026amp; cardiovascular medicine clinical trials\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Earrhythmias\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\u003Cp id=\u0022p-2\u0022\u003EThe addition of an educational program to apixaban therapy did not improve patient adherence to therapy. Gilles Montalescot, MD, PhD, Piti\u00e9-Salp\u00eatri\u00e8re Hospital, Paris, France, presented data from the AEGEAN study [\u003Ca class=\u0022external-ref external-ref-type-clintrialgov\u0022 href=\u0022\/lookup\/external-ref?link_type=CLINTRIALGOV\u0026amp;access_num=NCT01884350\u0026amp;atom=%2Fspmdc%2F15%2F28_suppl_2%2F9.1.atom\u0022\u003ENCT01884350\u003C\/a\u003E].\u003C\/p\u003E\u003Cp id=\u0022p-3\u0022\u003EVitamin K antagonists have multiple limitations, including regular laboratory monitoring to ensure that the INR is maintained within the narrow therapeutic window, frequent dose adjustments, multiple food and drug interactions, and the risk of bleeding [Mani H, Lindhoff-Last E. \u003Cem\u003EDrug Des Devel Ther\u003C\/em\u003E. 2014]. In contrast, the novel (nonwarfarin) oral anticoagulants (NOACs) have fixed dosing, do not require laboratory monitoring, and have few food or drug interactions [Heidbuchel H et al. \u003Cem\u003EEuropace\u003C\/em\u003E. 2013]. However, patient adherence to NOAC therapy has been suboptimal because patients do not undergo frequent monitoring at an anticoagulation clinic. The purpose of the AEGEAN trial was to assess the efficacy of an education program in improving adherence to apixaban.\u003C\/p\u003E\u003Cp id=\u0022p-4\u0022\u003EAdherence consists of 3 phases: (1) initiation, which occurs when the first dose is received, typically during hospitalization; (2) implementation, which refers to the patient\u2019s actual dosing relative to the prescribed dose; and (3) persistence, which is the time that a dose is omitted and no additional doses are taken.\u003C\/p\u003E\u003Cp id=\u0022p-5\u0022\u003EIn the open-label, phase 4 AEGEAN trial, patients with atrial fibrillation with a CHADS\u003Csub\u003E2\u003C\/sub\u003E score \u2265\u20051 were randomly assigned to receive apixaban with the standard of care or apixaban plus an educational program that consisted of an education booklet about atrial fibrillation and anticoagulation for stroke prevention, a key ring, a short message service alert via a mobile phone, a smartphone application, and access to a virtual clinic with staff from an existing anticoagulation clinic. The standard of care consisted of the usual information about apixaban treatment. After 24 weeks, patients who received the education program were randomly assigned to receive the standard of care or to continue the education program for an additional 24 weeks.\u003C\/p\u003E\u003Cp id=\u0022p-6\u0022\u003EThe primary end point was the effect of education on the implementation phase of adherence at 24 weeks. The secondary end points included the effect of education on the persistence phase of adherence at 24 weeks, the effect of an education program on efficacy and safety of apixaban, and identification of predictive risk factors for nonadherence. Patients were excluded if they were at a high risk of bleeding, could not self-administer apixaban, were hospitalized, or were in long-term residential care.\u003C\/p\u003E\u003Cp id=\u0022p-7\u0022\u003EThere was no significant difference in the implementation phase of adherence among the treatment arms at 24 weeks. Similarly, the rate of persistence at 24 weeks was 91.1% in the arm that received the education program compared with 90.5% in the standard-of-care arm. In addition, there was no significant difference in clinical outcomes at week 24 between the treatment arms.\u003C\/p\u003E\u003Cp id=\u0022p-8\u0022\u003EIn conclusion, Prof Montalescot stated that overall the data suggest that there is a high rate of adherence and persistence to apixaban during the first 6 months of therapy. However, the addition of an education program did not further improve adherence. The effect of the education program beyond 6 months will be evaluated in the second portion of the AEGEAN trial.\u003C\/p\u003E\u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2015 SAGE Publications\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/15\/28_suppl_2\/9.1.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzl7kq\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}