Overview of direct oral anticoagulation trends in the Bronx: case control study of patient and systemic factors in medication non-adherence

BACKGROUND: Anticoagulation non-adherence is attributed to myriad factors in patient populations across the world. While direct oral anticoagulants (DOACs) have demonstrated several clinical advantages over other anticoagulant classes, non-adherence persists and the underlying contributors vary by geography. OBJECTIVE: Outline patient and system level factors involved in DOAC non-adherence in the Bronx. METHODS: This retrospective review used all available electronic medical records on patients receiving active DOAC therapy from primary care centres in the Bronx between 2017-2024. Adherent and non-adherent groups were determined by prescription fill status and provider documentation. The two groups were compared by age, gender, race, ethnicity, insurance type, diagnostic indication for DOAC, pharmacy type, employment status, number of comorbidities, number of home medications and primary language. Univariable and multivariable logistic regressions were applied between the groups and categories. P values