Patients, as well as healthcare providers, may fail to adhere to published guidelines for anticoagulation therapy
in AF. For example, we found that 54% of patients in our study had a gap in therapy of >60 days. Such treatment
gaps may have numerous causes. Often, patients have a limited understanding of the value of vitamin K
antagonist therapy for stroke prophylaxis, and many are unaware of the risks associated with overanticoagulation
or underanticoagulation. As a result, INR monitoring visits at anticoagulation clinics are frequently missed,
INR values are frequently out of range, and dose adjustments are often required, particularly in theelderly.In
addition, treatment with a vitamin K antagonist is also often perceived as a burden on lifestyle, restricting diet,
social life, career, independence, and physical activities.