Patients with non-valvular atrial fibrillation who do not receive adequate anticoagulation are at increased risk of embolic events compared with those continuously receiving the recommended treatment; poor adherence to anticoagulation can impact stroke protection.

This was the first prospective, randomized study investigating the impact of an education program on total days of adherence and persistence to a non-vitamin-K oral anticoagulant (apixaban).

Implementation adherence and persistence rates were high over the first 48 weeks of administration, with attrition over time, with or without additional patient education; lack of impact of the educational intervention may be related to the experience of the investigators (high level of standard care) and limited uptake of digital support strategies.