Evaluation of medication compliance for secondary prevention of acute coronary syndrome
Dalvir Gill1, Elizabeth A Feldman1, Kan Liu1
1Department of Internal Medicine (Gill), Department of Pharmacy (Feldman), and Division of Cardiology (Liu), State University of New York Upstate Medical University, Syracuse, New York.
Insights
Adherence to guideline-recommended five-drug therapy after acute coronary syndrome (ACS) is suboptimal. Improving medication adherence is crucial for preventing ACS recurrence and improving patient outcomes.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- National guidelines recommend a five-drug combination therapy to prevent acute coronary syndrome (ACS) recurrence.
- Adherence to these medication regimens is critical for patient outcomes.
Purpose of the Study:
- To assess the proportion of patients discharged with all five guideline-recommended medications after ACS.
- To identify reasons for nonadherence to the five-drug therapy.
Main Methods:
- Retrospective chart review of 155 adult patients admitted with ACS.
- Data collected on medications prescribed at discharge and documented reasons for nonadherence.
Main Results:
- Half of the patients (78/155) were not discharged on the complete five-drug regimen.
- Among those not on all five drugs, 62% (48/78) had documented reasons for nonadherence.
Conclusions:
- Adherence to guideline-recommended five-drug therapy post-ACS requires improvement.
- Further investigation into barriers to adherence is needed to optimize secondary prevention.
Abstract:
To prevent recurrence of acute coronary syndrome (ACS), national practice guidelines recommend use of five-drug combination therapy. Our study assessed the proportion of patients discharged on all five medications following ACS and determined reasons for nonadherence. A retrospective, single-center chart review was conducted at a tertiary academic medical center. Patients 18 years and older who were admitted to the cardiac care unit with a diagnosis of ACS between January 2013 and January 2015 were included. Overall, 200 patients were screened and 155 were included in the study. Half of the patients received all guideline-recommended classes of pharmacological agents at discharge. The other half-78 patients-did not receive the five-drug combination, of whom 48 (62%) had reasons documented for nonadherence. Our study's findings suggest that rates of adherence need to improve given the clear benefits of these medications.
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