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Long-term adherence with cardiovascular drug regimens
Sonali P Kulkarni1, Karen P Alexander, Barbara Lytle
1Duke Clinical Research Institute, Durham, NC, USA.
American Heart Journal
|December 22, 2005
Summary
Many patients with coronary artery disease stop taking prescribed cardiovascular medications within a year. Adherence is linked to mental health, education, marital status, and the number of medications.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Patient Adherence Research
Background:
- Coronary artery disease (CAD) patients often receive multiple medications.
- Poor medication adherence can significantly limit treatment benefits.
- Optimizing adherence is crucial for effective CAD management.
Purpose of the Study:
- To assess adherence to evidence-based cardiovascular medications at one year post-discharge.
- To identify predictors of medication nonadherence in CAD patients.
Main Methods:
- A cohort of 1326 CAD patients undergoing cardiac catheterization were studied.
- Adherence to angiotensin-converting enzyme (ACE) inhibitors, aspirin, beta-blockers (BBs), and statins was evaluated at 12 months via self-report.
- Clinical and demographic factors associated with nonadherence were analyzed.
Main Results:
- At discharge, aspirin (95%), BBs (86%), ACE inhibitors (65%), and statins (55%) were prescribed.
- Medication discontinuation rates were highest for ACE inhibitors/angiotensin receptor blockers (28%) and statins (28%).
- Only 54% of patients adhered to all prescribed medications; nonadherence was linked to older age, female sex, being unmarried, and lower education.
Conclusions:
- A significant proportion of CAD patients discontinue prescribed medications within one year.
- Adherence is influenced by psychosocial factors (marital status, mental health, education) and medication burden.
- Healthcare providers should consider patient-specific factors to improve medication adherence in CAD.