Robin Mathews|Eric D. Peterson|Emily Honeycutt|Chee Tang Chin|Mark B. Effron|Marjorie E. Zettler|Gregg C. Fonarow|Timothy D. Henry|Tracy Y. Wang
Early Medication Nonadherence After Acute Myocardial Infarction
Clinical Research Institute|Abbott Northwestern Hospital|Minneapolis Heart Institute Foundation|Clinical Research Institute|Abbott Northwestern Hospital|Minneapolis Heart Institute Foundation|Clinical Research Institute|Abbott Northwestern Hospital|Minneapolis Heart Institute Foundation|Clinical Research Institute|Abbott Northwestern Hospital|Minneapolis Heart Institute Foundation|Clinical Research Institute|Abbott Northwestern Hospital|Minneapolis Heart Institute Foundation|Clinical Research Institute|Abbott Northwestern Hospital|Minneapolis Heart Institute Foundation|Clinical Research Institute|Abbott Northwestern Hospital|Minneapolis Heart Institute Foundation|Clinical Research Institute|Abbott Northwestern Hospital|Minneapolis Heart Institute Foundation|Clinical Research Institute|Abbott Northwestern Hospital|Minneapolis Heart Institute Foundation
background nonadherence prescribed evidencebased medications acute myocardial infarction mi contribute worse outcomes higher costs sought better understand modifiable factors contributing early nonadherence evidencebased medications acute mi methods results assessed 7425 acute mi patients treated percutaneous coronary intervention 216 us hospitals participating treatment adp receptor inhibitors longitudinal assessment treatment patterns events acute coronary syndrome translateacs april 2010 may 2012 using validated morisky instrument assess cardiovascular medication adherence 6 weeks post mi stratified patients selfreported high score 8 moderate score 67 low score lt6 adherence groups moderate low adherence reported 25 4 patients respectively one third low adherence patients described missing doses antiplatelet therapy least twice week percutaneous coronary intervention signs depression patientreported financial hardship medication expenses independently associated higher likelihood medication nonadherence patients likely adherent 6 weeks followup appointments made discharge provider explain potential side effects medications lower medication adherence may associated higher risk 3month deathreadmission adjusted hazard ratio 135 95 confidence interval 098187 although reach statistical significance conclusions even early mi substantial proportion patients report suboptimal adherence prescribed medications tailored patient education pre discharge planning may represent actionable opportunities optimize patient adherence clinical outcomes clinical trial registration url httpwwwclinicaltrialsgov unique identifier nct01088503