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Adherence to dual antiplatelet therapy: can we do better?

Srinivas Yallapragada1, Saifullah Siddiqui, Ryan Gindi

  • 1Division of Cardiology, University of Illinois at Chicago, IL, USA.

Expert Review of Cardiovascular Therapy
|October 22, 2013
PubMed

Insights

Improving medication adherence for dual antiplatelet therapy after percutaneous coronary intervention is crucial. This review highlights the importance of this therapy, the consequences of stopping it early, and strategies for better patient compliance.

Area of Science:

  • Cardiology
  • Pharmacology
  • Health Services Research

Background:

  • Medication adherence remains a significant challenge for patients post-percutaneous coronary intervention (PCI).
  • Non-compliance with dual antiplatelet therapy (DAPT) is alarmingly high.
  • Current management strategies have not evolved to address this critical issue.

Purpose of the Study:

  • To underscore the vital role of dual antiplatelet therapy (DAPT) in patients undergoing PCI.
  • To examine the clinical and economic consequences of premature DAPT discontinuation.
  • To propose actionable strategies for enhancing medication adherence.

Main Methods:

  • Literature review focusing on DAPT adherence post-PCI.
  • Analysis of clinical outcomes associated with non-adherence.
  • Examination of economic impacts of treatment failure.
  • Synthesis of evidence-based strategies for improving adherence.

Main Results:

  • Premature DAPT discontinuation is linked to increased risks of stent thrombosis and major adverse cardiovascular events.
  • Poor adherence incurs substantial healthcare costs due to recurrent cardiovascular events and rehospitalizations.
  • Several patient-centered and system-level strategies show promise for improving adherence.

Conclusions:

  • Optimizing DAPT adherence is essential for long-term patient outcomes after PCI.
  • Addressing the clinical and economic burdens of non-adherence requires innovative management approaches.
  • Future interventions should focus on personalized strategies to support patients in adhering to DAPT regimens.

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