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Impact of adherence to drugs for secondary prevention on mortality and cardiovascular morbidity: A population-based

Gerard Sotorra-Figuerola1,2, Dan Ouchi1,2, Maria Giner-Soriano1,2

  • 1Fundació Institut Universitari per a la Recerca a l'Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain.

Pharmacoepidemiology and Drug Safety
|May 3, 2021
PubMed

Insights

Adherence to cardiovascular drugs after acute coronary syndrome (ACS) significantly lowers the risk of major adverse cardiovascular events (MACE). Higher adherence to multiple medications is linked to reduced mortality, emphasizing the importance of medication compliance for secondary prevention.

Area of Science:

  • Cardiology
  • Public Health
  • Pharmacology

Background:

  • Secondary prevention after acute coronary syndrome (ACS) relies on pharmacological therapy.
  • Studies indicate suboptimal adherence to these crucial medications.
  • Poor adherence increases the risk of recurrent cardiovascular events.

Purpose of the Study:

  • To evaluate the association between adherence to secondary prevention medications and the risk of major adverse cardiovascular events (MACE) and all-cause mortality.
  • To assess this risk within a primary health care cohort following an ACS event.

Main Methods:

  • Population-based observational cohort study.
  • Inclusion of patients with a first ACS episode between 2009-2016.
  • Drug adherence assessed using Proportion of Days Covered (PDC) from the SIDIAP database.

Main Results:

  • 79.6% of 7152 patients were adherent (PDC ≥ 75%) in the first year post-ACS.
  • Adherence to any drug combination significantly reduced composite endpoint risk (HR 0.80).
  • Adherence to 2 or 1 drug was associated with higher composite endpoint risk compared to 3-4 drugs.

Conclusions:

  • Adherence to any combination of recommended drugs post-ACS reduces composite endpoint risk.
  • Higher adherence to 3-4 medications is linked to reduced mortality risk compared to 1-2 medications.
  • Medication adherence is crucial for secondary cardiovascular event prevention.
Abstract

Keywords:
acute coronary syndromecoronary heart diseaseelectronic health recordsmedication adherencepharmacoepidemiologyprimary health caresecondary prevention

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