People who have had a heart attack or unstable angina (chest pains related to inadequate blood supply to the heart) are more likely to die or return to the hospital if they don’t regularly take prescribed medication to control blood pressure, prevent blood clotting, control cholesterol, and reduce the risk for worsening of their heart blockages.
According to earlier studies, within a month, a third of patients stop taking at least one drug, and within a year of discharge, 40 percent are no longer taking cholesterol-lowering medications as prescribed.
In the Multifaceted Intervention to Improve Medication Adherence and Secondary Prevention Measures (Medication Study) After Acute Coronary Syndrome Hospital Discharge study, patients discharged from four Veterans Administration (VA) hospitals after treatment for heart attack or unstable angina got standard care or enhanced follow-up. Enhanced care included:
In the year after hospital discharge, 89 percent of 122 enhanced-care patients refilled their prescriptions and 74 percent of 119 usual-care patients did.
There was no difference in the proportion of patients in each group who achieved blood pressure or cholesterol-lowering goals.
“These results suggest that hospitals and providers should develop systems of care to improve and maintain adherence to medications shown to reduce the risk of recurrent heart attacks and death,” said P. Michael Ho, M.D., Ph.D., study author and staff cardiologist at VA Eastern Colorado Health Care System in Denver.
“The adherence levels in this study for both the enhanced follow-up and standard care groups were higher than adherence levels seen in many other patient groups, so an enhanced system such as the one studied might have an even greater impact outside of the VA.”
The typical intervention cost for the year was about $360 per patient.
Co-authors are Anne Lambert-Kerzner, Ph.D., M.S.P.H.; Evan P. Carey, M.S.; Ibrahim E. Fahdi, M.D.; Chris L. Bryson, M.D., M.S.; S. Dee Melnyk, Pharm.D., M.H.S.; Hayden B. Bosworth, Ph.D.; Tiffany Radcliff, Ph.D.; Ryan Davis, Pharm.D.; Howard Mun, Pharm.D.; Jennifer Weaver, Pharm.D.; Casey Barnett, Pharm.D.; Anna Baron, Ph.D. and Eric J. Del Giacco, M.D., Disclosures
The Veterans Health Administration study funded the study.
For more information about recovering from a heart event, read Heart Attack Recovery FAQs.
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Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect association policy or position. The association makes no representation or warranty as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding.
Note: Actual presentation is 9:44 a.m. CT/10:44 a.m. ET Monday, Nov. 18, 2013 in Ballrooms C1 & C2.