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Open Access Highly Accessed Editorial

New oral anticoagulants: discussion on monitoring and adherence should start now!

Hugo ten Cate

Author Affiliations

Department of Internal Medicine, Laboratory for Clinical Haemostasis and Thrombosis, Maastricht University Medical Center, PO Box 616, Maastricht, MD, 6200, the Netherlands

Cardiovascular Research Institute Maastricht, PO Box 616, Maastricht, MD, 6200, the Netherlands

Thrombosis Journal 2013, 11:8  doi:10.1186/1477-9560-11-8

Published: 28 June 2013

Abstract

New oral anticoagulants (NOACs) have been introduced to improve anticoagulant therapy worldwide, but safe implementation may require additional measures. First, optimization of dose adjustment based on therapeutic levels of the drug may be more appropriate than fixed dose therapy. The development and implementation in quantitative laboratory assays will enable further dose optimization. Second, non-adherence to medication is a potential threat to the safe use of NOACs. Since cardiovascular medication may not be optimally used in about 50% of patients, procedures to improve adherence are imperative, also for NOAC therapy and in particular in elderly patients.

Keywords:
New oral anticoagulants; Adherence; Vitamin K antagonists; Laboratory assays