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  • Alvina Lai

Commentary for our adherence paper in the Lancet Regional Health

We published a paper in the Lancet Regional Health Europe on antithrombotic medication adherence in patients with liver disease.


Peter Calvert, Dhiraj Gupta and Gregory Lip wrote a commentary to highlight the key findings of our work.


“The present study adds to the long-held suspicion that clinicians may be hesitant to prescribe antithrombotic medications (specifically, anticoagulants) to patients they perceive to have an increased bleeding risk. Such practice is frequently based on the misplaced notion that CLD patients with raised INR are “auto-anticoagulated”. In fact, it has been shown that these patients may actually be at higher thrombotic risk, particularly in the setting of hypoalbuminaemia”

“In summary, although the haemostatics of liver failure are complex, the concept of “auto-anticoagulation” is incorrect and increasing evidence suggests anticoagulants may not only be safe in most CLD patients but may have an important treatment role. Further research is needed to fully define this. The suboptimal prescribing practices and factors relating to adherence and persistence described by Chang et al bear emphasis if we are to optimally manage this complex patient group.”

We couldn’t agree more!