Risk factors affect long-term compliance to coumadin treatment (self-reporting)

Lilian Tzivian*, Valdis Folkmanis, Lora Warshawsky-Livne, Maor Waldman, Michael Friger, Haim Reuveni, Ronit Yerushalmi

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Low compliance to a prescribed Coumadin treatment can result in negative health outcomes. In this study we aimed to evaluate risk factors affecting patient compliance to Coumadin. For this purpose, two study phases were performed: Phase 1: a retrospective eight-year follow-up of databases from health care services; and Phase 2: a cross-sectional study with telephone interviews. A Total Compliance Index was constructed using the number of Coumadin purchases (40%), international standardised ratio (INR) tests (40%), and average INR values (20%). Multiple models for the Total Compliance Index were constructed using socio-demographic, treatment-related, and health care utilisation variables, use of drugs, patient-physician relationships and patient's quality of life. 78.5 ± 3.4% of patients in the total population were non-compliant in the retrospective phase of the study, and 53.2% in the second, cross-sectional phase. Total Compliance Index was significantly associated with older age, number of doctor visits, and drugs from group C. We suggest that the Total Compliance Index for other drugs can be utilised as well.

Original languageEnglish
Pages (from-to)14-21
Number of pages8
JournalProceedings of the Latvian Academy of Sciences, Section B: Natural, Exact, and Applied Sciences
Issue number1-2
StatePublished - Apr 2017
Externally publishedYes


  • Anti-coagulant treatment
  • Compliance to treatment
  • Coumadin
  • International standardised ratio (INR)
  • Total Compliance Index


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