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Analyzing Poor Medication Adherence After MI

Analyzing Poor Medication Adherence After MI

Approximately, 1.5 million cases of myocardial infarction (MI) occur each year. An estimated 5% to 10% of patients who survive an MI die within the first year after the index event, and half are rehospitalized. Studies have demonstrated that medications such as aspirin, β-blockers, ACE inhibitors, and statins taken after MI are associated with improved short- and long-term outcomes, providing protection against subsequent cardiovascular events. Despite proven benefits, a large proportion of patients who have had an MI appear to discontinue use of their prescribed medications over time. Most medications should be taken indefinitely, but long-term data on factors affecting medication adherence are lacking. New Data on Medication Adherence In a study published in the October 2009 American Journal of Medicine, my colleagues and I published an analysis assessing patients hospitalized with MI from 1997 to 2006 to determine adherence to statins, β-blockers, and ACE inhibitors/angiotensin receptor blockers (ARBs). The study also looked at factors that appeared to be associated with improved adherence. Data demonstrated that adherence to guideline-recommended medications decreased over time, with 3-year medication continuation rates of 44%, 48%, and 43% for statins, β-blockers, and ACE inhibitors/ARBs, respectively. Our findings illustrated that many patients discontinued use of prescribed cardioprotective medications after MI, with less than half continuing medications 3 years after their MI. Results were particularly striking because the study included patients who were well-insured with relatively low out-of-pocket expenses for prescription drugs. Considering the insurance status of the patients assessed, adherence is presumably even worse among the general population. Assessing Adherence Factors A potential cause of poor medication adherence after MI may be a “knowledge translation...
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