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Trends in adherence to secondary prevention medications in elderly post-myocardial infarction patients

Niteesh K Choudhry1, Soko Setoguchi, Raisa Levin

  • 1Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA. nchoudhry@partners.org

Pharmacoepidemiology and Drug Safety
|October 29, 2008
PubMed

Insights

Medication adherence for heart disease patients improved slightly over time for statins and beta-blockers but not ACEI/ARBs, remaining suboptimal. Strategies to enhance adherence are crucial due to high non-adherence rates.

Area of Science:

  • Cardiology
  • Pharmacology
  • Health Services Research

Background:

  • Medication adherence in coronary heart disease (CHD) patients is historically poor.
  • The trend of medication adherence over time for CHD patients is not well-established.

Purpose of the Study:

  • To evaluate trends in medication adherence after acute myocardial infarction (MI).
  • To assess changes in adherence to statins, ACEI/ARBs, and beta-blockers over time.

Main Methods:

  • Retrospective cohort study of lower-income Medicare beneficiaries hospitalized for their first MI (1995-2003).
  • Medication adherence measured by proportion of days covered (PDC) in the year following discharge.
  • Analysis included patients prescribed statins, ACEI/ARBs, beta-blockers, or all three.

Main Results:

  • Adherence rates for statins and beta-blockers significantly increased from 1995 to 2003, but remained suboptimal.
  • For example, statin adherence increased from 38.6% to 56.2% (p<0.001).
  • Adherence to ACEI/ARBs did not show significant improvement over the study period.

Conclusions:

  • Modest improvements in medication adherence for statins and beta-blockers were observed post-MI.
  • However, non-adherence rates for these critical therapies remain high.
  • Developing cost-effective strategies to improve medication adherence is a priority given the associated health and economic consequences.
Abstract

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