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Compliance and refill pattern behavior with HMG-CoA reductase inhibitors after acute myocardial infarction
John H Coombs1, Laura Cornish, Paula Hiller
1Global Outcomes Research Department, Pfizer Inc, Ann Arbor, Michigan, USA. john.coombs@pfizer.com
Insights
Improving patient adherence to HMG-CoA reductase inhibitors after atherosclerotic events is crucial. Longer prescription supplies, fewer concomitant medications, and lower copays are key factors for enhancing medication compliance in cardiovascular patients.
Area of Science:
- Cardiology
- Pharmacology
- Health Outcomes Research
Background:
- Adherence to statin therapy (HMG-CoA reductase inhibitors) is critical for secondary prevention in patients with atherosclerotic cardiovascular disease.
- Understanding factors influencing medication compliance is essential for optimizing treatment outcomes.
Purpose of the Study:
- To identify factors associated with medication compliance in patients prescribed HMG-CoA reductase inhibitors following an acute atherosclerotic event.
- To explore strategies for improving compliance with these vital lipid-lowering medications.
Main Methods:
- Retrospective analysis of patients with a history of myocardial infarction or other atherosclerotic events who filled prescriptions for HMG-CoA reductase inhibitors.
- Assessment of medication compliance using a multiple-interval refill compliance score.
- Regression analysis to identify predictors of compliance.
Main Results:
- The mean compliance score was 80%, with six distinct refill patterns observed.
- Key factors significantly associated with improved compliance included longer days' supply of medication (60- or 90-day vs. 30-day), a lower number of total concomitant medications, and reduced cost-sharing (copayments).
Conclusions:
- Medication compliance with HMG-CoA reductase inhibitors in high-risk cardiovascular patients can be improved through strategic interventions.
- Prescribing longer medication supplies, rationalizing concomitant medications, and reducing patient copayments are recommended strategies to enhance adherence and potentially improve long-term cardiovascular outcomes.
Abstract:
Patients who had an acute myocardial infarction or other atherosclerotic event and had filled a prescription for an HMG-CoA reductase inhibitor were identified for analysis. Compliance was assessed using a multiple-interval refill compliance score. The mean compliance score was 80% and six refill patterns were identified. Regression analysis revealed three factors associated with compliance: (1) days' supply, (2) number of total concomitant medications, and (3) cost sharing. Strategies for improving compliance that may have merit include providing patients with 60- or 90-day supplies (rather than 30-day supplies), controlling the number of other medications prescribed, and lowering copayments for these important medications.