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 Only 7 percent of smokers picked up a prescription for a smoking
cessation drug during the 90 days following their heart attacks,
researchers found.
"These medications are being underused," said lead author Dr. Neha
Pagidipati, of Duke University in Durham, North Carolina. "Now we
need to understand why."
About 735,000 people in the United States have heart attacks each
year, according to the Centers for Disease Control and Prevention
(CDC). Smoking is a major cause of cardiovascular disease.
The CDC says one in three deaths from cardiovascular disease can be
blamed on smoking.
Pagidipati and colleagues write in JAMA Cardiology that despite the
increased risk, just over half of people stop smoking in the year
after a heart attack.
Along with nicotine replacement therapies like gum and patches,
people trying to quit cigarettes can use medications such as
bupropion and varenicline.
"What we didn’t know is how often are these medication being used in
patients who recently had a heart attack," Pagidipati told Reuters
Health.
For the new study, researchers analyzed data on 9,193 smokers who
had a heart attack between 2007 and 2013. All were at least 65 years
old.
Overall, 97 percent of patients were counseled during their hospital
stay about smoking cessation, but only 7 percent ended up picking up
medications to help achieve that goal within 90 days.
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"It suggests somewhere in there is a break in the link," said
Pagidipati. "Now we need to go back and figure out where is the
problem."
Of those who did pick up a prescription, about 53 percent used
varenicline and about 47 percent used bupropion. But only about 37
percent of those taking bupropion and only about 20 percent of those
taking varenicline used them for the recommended 12 weeks.
About half of the patients using bupropion took the drug for less
than 6.2 weeks. Similarly, about half of the patients on varenicline
used it for less than 4.3 weeks.
Pagidipati said it's not clear whether doctors are not prescribing
the medications or patients aren't filling their prescriptions due
to fear of side effects or cost.
The drugs are powerful tools, she said. She urges people to ask
their healthcare providers as soon as possible about how to stop
smoking.
"There are a lot of things that can be done," said Pagidipati. "It’s
absolutely imperative that they speak to their providers."
SOURCE: http://bit.ly/2uHm1Lm JAMA Cardiology, online July 19, 2017.
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