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National Adherence to Medical Management of Aortic Aneurysms

William L Patrick1, Fabliha Khurshan2, Joseph E Bavaria2

  • 1Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia; Leonard Davis Institute, University of Pennsylvania, Philadelphia; Penn Cardiovascular Outcomes, Quality, & Evaluative Research Center, Philadelphia, Penn.

The American Journal of Medicine
|July 12, 2022
PubMed

Insights

Adherence to medical management for aortic aneurysms is low, varying by subtype and decreasing over time. Patients with aortic aneurysms showed lower adherence rates compared to those with coronary artery disease.

Area of Science:

  • Cardiovascular Medicine
  • Pharmacology
  • Health Services Research

Background:

  • Guideline-based medical management is crucial for patients with aortic aneurysms.
  • Adherence to these guidelines in aortic aneurysm patients has not been previously studied.
  • Coronary artery disease (CAD) patients serve as a comparator group due to established adherence benchmarks.

Purpose of the Study:

  • To determine adherence levels to guideline-based medical management in patients diagnosed with aortic aneurysms.
  • To compare adherence rates between aortic aneurysm subtypes (thoracic, abdominal) and a CAD cohort.
  • To identify trends in adherence over time.

Main Methods:

  • Retrospective cohort study of adult patients diagnosed between 2004-2018 using deidentified claims data.
  • Aortic aneurysms subclassified into thoracic, abdominal, or both.
  • Adherence defined as receipt of indicated antihypertensive or antihyperlipidemic medications post-diagnosis; compared using univariable logistic regression.

Main Results:

  • 194,144 aortic aneurysm patients and 3,946,782 CAD patients identified.
  • Overall adherence for aortic aneurysms was low at 45.0%, with variations by subtype (thoracic: 45.9%, abdominal: 42.6%).
  • Adherence declined by ~15% after one year; aortic aneurysm patients had significantly lower odds of adherence than CAD patients.

Conclusions:

  • Adherence to medical management for aortic aneurysms is notably low and diminishes over time.
  • Adherence rates differ significantly across aortic aneurysm subtypes.
  • Aortic aneurysm patients exhibit lower adherence compared to coronary artery disease patients, highlighting a target for intervention.
Abstract

Keywords:
AdherenceAortic aneurysmCoronary artery diseaseMedical managementTreatment

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