This mixed-methods study examined medication adherence among patients with non-valvular atrial fibrillation (AF) taking oral anticoagulants (OACs). Among 213 surveyed patients, 68.5% were adherent to their medications, while 31.5% reported non-adherence. Patients who received clear information from clinicians and felt confident managing their health were more likely to adhere to treatment. Poor healthcare experiences, lower self-efficacy, social needs, and perceived discrimination were linked to non-adherence. Interviews revealed that trust in clinicians, effective communication, belief in medication benefits, and medication reminders were major adherence drivers. Cost, side effects, and managing multiple medications were common barriers. Clinicians, however, perceived adherence to be much lower than patients reported, with 87% believing non-adherence was common. Both patients and clinicians agreed that better communication and shared decision-making are essential. The study highlights the need for personalized interventions that improve patient education, confidence, access to medications, and clinician-patient relationships. Strengthening these factors could significantly improve medication adherence and health outcomes in AF patients.
