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Volume 31, Nº 4, July and August 2018


DOI: http://www.dx.doi.org/10.5935/2359-4802.20180028


Adherence Score for Users of Oral Anticoagulants

Sérgio Henrique Simonetti

Ana Cristina Mancussi e Faro

Estela Regina Ferraz Bianchi


Background: The score is an effective instrument for the assessment of treatment adherence in users of oral anticoagulants and maintenance of INR (international normalized ratio) within the therapeutic range.

Objective: To develop an adherence score for oral anticoagulant users for the maintenance of INR within the therapeutic range.

Methods: This was an analytical, observational, cross-sectional study, with a quantitative approach, conducted in a public cardiology hospital. A total of 607 patients who met the inclusion criteria were evaluated. Variables with a significance level of 5% in the exploratory analysis and considered clinically relevant were included and subjected to a multiple logistic regression model. Predictive accuracy of the model was determined using the C statistic.

Results: The variables with a significance level of 5% in the multivariate analysis were: education, family income, inadequate use of medications, drug-drug interactions, invasive procedures, food-drug interactions, physical activity, medical conditions, other factors, and complications related to oral anticoagulant therapy. The following prognostic variables were identified: family income, inadequate use of medications, invasive procedures, drugdrug interactions, dietary habits, medical conditions, other factors (stress, thinness, weight loss). C-statistic for adherence score was 0.94.

Conclusion: The Simonetti adherence score proved to be easily applicable and feasible, with high predictive value for influencing factors, promoting the improvement of adherence and maintenance of INR in the ideal range. (Int J Cardiovasc Sci. 2018;31(4)383-392)

Keywords: Cardiovascular Diseases; Anticoagulants/therapy; Probability; Medication Adherence; Health Education.