Grant: Catalyst Grant: Post Market Drug Safety and Effectiveness

Background: Atrial fibrillation (AF) is the most common arrhythmia requiring medical care. Medication is the cornerstone of AF management, with new medication for AF treatment. Older drugs will face competition from new drugs, which are supposed to be more patient friendly. However there is a lack of information from clinical trials on the new medication in the elderly population. We believe that adherence to current AF therapy is one of the main elements that can optimize care and maximize beneficial outcomes, especially in the older population. Given that the majority of AF patients are elderly patients, treated outside of the hospital, there is a need to measure the adherence to current AF medications in the 'real world' setting. Objectives: The objective of this study is to measure adherence to AF medications in the 'real world' setting. Methods: We propose to conduct a study using health services data, linking hospital discharged database with prescription drug claims. This unique dataset will contains data for patients 65 years and older, with a diagnosis of AF between 1998 and 2010, in the provinces of Quebec, Ontario and British Columbia. In this study we will evaluate the extent to which patients adhere to their prescription regimens and will identify factors associated with non-adherence. Significance: Assessment of the extent, risk factors and adverse outcomes associated with non-adherence in the AF setting is required in order to improve the quality of AF treatment in the elderly. Implementation of the study results may enhance adherence to AF therapies, which may result in improved outcomes.