Monday, July 20, 2009

Many Heart Patients Stop Taking Their Medications

Nearly a third of heart patients drop some of their meds within three months after hospital discharge

20 july 2009-- Nearly a third of patients prescribed evidence-based medicine after hospitalization for acute coronary syndrome discontinue one or more of their medications within three months, according to a study in the July 15 issue of the American Journal of Cardiology.

Chiara Melloni, M.D., of Duke University Medical Center in Durham, N.C., and colleagues conducted post-discharge telephone interviews with patients who had been hospitalized with acute coronary syndrome during 2006 and 2007, to determine if they had continued on prescribed medications. The medications were ascertained from hospital records and included several classes of evidence-based medicine: aspirin, clopidogrel, beta-blockers, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, and lipid-lowering drugs. The researchers asked patients who had stopped a medication whether it was done with their physician's knowledge or on their own.

By three months after discharge, the researchers found that 28.2 percent of patients had stopped taking one or more of the prescribed medications, with 61.5 percent of those categorized as self-discontinuations. The leading factors associated with self-discontinuation were lack of pharmacy coinsurance, discomfort with an increasing number of medications, failure to use a reminder tool (such as a pillbox), lower education, and dialysis.

"In conclusion, one-third of patients with acute coronary syndrome discontinue greater than or equal to one of their prescribed evidence-based medicines within three months of hospital discharge, and most of this discontinuation is without provider involvement. Patient education, better prescription drug coverage, and reminder strategies may improve use of evidence-based medicines at three months after discharge from acute coronary syndrome admission," the authors write.

The study was funded by Bristol-Myers Squibb/Sanofi-Aventis Pharmaceuticals partnership and by Merck Schering-Plough Pharmaceutical.

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