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Published on: January 18, 2018
Patient Acceptance and Adherence to the COMPASS Trial Drug Recommendations Following Symptomatic Carotid
Daryll Baker1, Lucinda Cruddas2, Tom Eveson3
1Department of Vascular Surgery, Royal Free London NHS Foundation, Trust, London, UK; Vascular Surgery Service, The National Hospital for Neurology and, Neurosurgery, University College Hospitals NHS Foundation Trust, London, UK; UCL Division of Medicine, Royal Free Campus, University College London, London, UK.
Insights
Patients undergoing carotid endarterectomy showed high acceptance and adherence to the COMPASS drug regimen (rivaroxaban and aspirin), with no identified barriers to its use for reducing cardiovascular events.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Vascular Surgery
Background:
- The COMPASS trial established low-dose rivaroxaban and aspirin as superior to mono-antiplatelet therapy for preventing major adverse cardiovascular events (MACEs) in atherosclerotic disease.
- Optimal drug acceptance and adherence are crucial for maximizing the benefits of the COMPASS regimen.
- This study investigated patient acceptance and adherence to the COMPASS regimen post-carotid endarterectomy (CEA).
Purpose of the Study:
- To assess patient acceptance and adherence to the COMPASS drug regimen in individuals who have undergone carotid endarterectomy (CEA).
- To identify any patient-related barriers to the use of the COMPASS regimen in this specific patient population.
Main Methods:
- Sixty-three patients post-CEA were evaluated using the Beliefs about Medicine Questionnaire and the Sidorkiewicz scoring system for drug adherence.
- Views and adherence were compared to 54 patients on mono-antiplatelet therapy (MAPT).
- Incidence of side effects and new MACEs were recorded for both groups.
Main Results:
- Patients on the COMPASS regimen reported strong positive views on the necessity of their medication (necessity scale 19.6 ± 3.6).
- Concerns regarding the COMPASS regimen were not strongly held, resulting in a positive necessity-concerns differential (7.8 ± 6.2).
- Drug adherence was rated as "High" to "Good" (1.7 ± 1.0), with similar acceptance and adherence levels compared to MAPT. MACE and side effect rates were also comparable between groups.
Conclusions:
- Patients treated with the COMPASS regimen following CEA demonstrated positive attitudes towards their medication and high drug adherence.
- No patient-related barriers were identified that would hinder the use of the COMPASS regimen to further decrease cardiovascular events post-CEA.
Background:
The COMPASS trial demonstrated that in patients with atherosclerotic diseases, low-dose rivaroxaban and aspirin provides greater protection against subsequent major adverse cardiovascular events (MACEs) than mono-antiplatelet therapy (MAPT) alone. Drug acceptance and adherence maximizes this benefit. We have assessed drug acceptance and adherence to the COMPASS drug regime in patients following carotid endarterectomy (CEA) for symptomatic carotid artery stenosis.
Methods:
Following CEA, the views of 63 patients on the COMPASS drug regime were assessed using the Beliefs about Medicine Questionnaire and drug adherence was determined using the Sidorkiewicz scoring system. These views were compared with those of 54 patients on MAPT. Side effects (bleeding and drug reactions) and new MACE were recorded.
Results:
Post-CEA patients on the COMPASS drug regimen had strong positive views on the necessity to take these drugs (necessity scale 19.6 ± 3.6). Although there were some concerns about the COMPASS drug regimen, these were not strongly held (concern cscale 11.8 ± 4.9) and the necessity-concerns differential was positive (7.8 ± 6.2). The Drug Adherence Score was "High" to "Good" (level of drug adherence 1.7 ± 1.0). The Beliefs about Medicine Questionnaire scales and Drug Adherence Score of post-CEA patients on the COMPASS drug regimen were similar to those on MAPT. The incidence of post-CEA MACE and side effects were similar for those on the COMPASS drug regimen and MAPT.
Conclusions:
Post-CEA patients on the COMPASS drug regimen had positive views on taking the drugs and drug adherence was high. We did not identify any patient-related barriers to the use of the COMPASS drug regimen to further reduce cardiovascular events.
