Taking drugs at least every four out of five days lowered the odds
death, heart attack, stroke or surgery to restore blood flow, the
study found. But less than half of patients took their meds that
“We have effective, safe inexpensive drugs that prevent stroke,
death and heart attack but they don’t work unless the patient
chooses to take them,” said Dr. Marie Brown, a researcher at Rush
University Medical Center in Chicago.
“This confirms previous studies showing worse outcomes including
higher death rates with poor adherence,” Brown, who wasn’t involved
in the study, said by email.
For the current study, Dr. Valentin Fuster of Mount Sinai Heart in
New York and colleagues reviewed drug compliance for 4,015 heart
attack survivors and 12,976 patients hospitalized with
atherosclerosis, or clogged arteries.
All of the patients filled at least one prescription for drugs
commonly given after a heart attack or hospitalization to purge
debris from clogged arteries: cholesterol-lowering pills known as
statins that can help stop fresh deposits from accumulating in blood
vessels or drugs known as ACE inhibitors that widen blood vessels
and make it easier for the heart to pump blood through the body.
Among the heart attack survivors, only 43 percent were considered
fully compliant with prescribed drug regimens, a category that
included people who took medicines at least 80 percent of the time.
These patients were 19 percent less likely to have a repeat heart
attack, stroke or other serious cardiac complication than
counterparts who were only partially compliant, meaning they took
prescribed drugs anywhere from 40 percent to 79 percent of the time.
In the two years after their heart attacks, fully compliant patients
were 27 less likely to have serious complications or a repeat heart
attack than the so-called “non-adherent” group that took prescribed
drugs no more than 39 percent of the time.
With the group treated for clogged arteries, the trend was similar.
Over two years, patients who were fully compliant with drug
regiments were 44 percent less likely than the non-adherent group
and 24 percent less likely than the partially compliant group to
have serious complications like a heart attack or stroke.
Researchers also found a cost savings associated with taking drugs
For example, annual direct medical costs associated with
hospitalizations to restore blood flow were $844 lower for heart
attack survivors who were fully compliant with drug regimens than
for their non-adherent peers. In the group treated for clogged
arteries, these costs were $799 lower for fully compliant patients.
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Limitations of the study include its reliance on prescription data
to assess compliance, which might not accurately reflect how often
patients took their medications, the authors note in the Journal of
the American College of Cardiology.
Still, the findings confirm the importance of sticking with
prescribed drug regimens, said Dr. Ian Kronish, a researcher at
Columbia University Medical Center in New York who wasn’t involved
in the study.
“Missing a pill even twice per week is enough to place someone in
the non-adherent category associated with increased risk,” Kronish
said by email.
The study didn’t explore why patients failed to consistently take
It’s possible some people struggled with costs or side effects, said
Dr. Robin Mathews, a researcher at Duke University Medical Center in
Durham, North Carolina, who wasn’t involved in the study.
Often, patients may also stop prescribed drug regimens because they
don’t feel sick and incorrectly assume the pills are no longer
necessary, Mathews said by email.
“This study adds to the wealth of research that shows how important
it is for patients to adhere fully to their medication regimens and
stay on them,” said Steven Baroletti, director of pharmacy at
MetroWest Medical Center in Framingham, Massachusetts.
“The take home message for patients is that each medication
prescribed has an important role in your recovery and prevention of
future cardiac disease,” Baroletti, who wasn’t involved in the
study, added by email.
SOURCE: http://bit.ly/2bBFowW Journal of the American College of
Cardiology, online August 15, 2016.
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