Clinical research studyAdherence to Drugs That Prevent Cardiovascular Disease: Meta-analysis on 376,162 Patients
Section snippets
Materials and Methods
We searched medical databases (PubMed) for studies that assessed the extent to which individuals remained on coronary heart disease preventive drug therapy over time. The search terms used were [adherence, persistence, compliance, or concordance] and [drug treatment, aspirin, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium channel blockers, thiazide diuretics, or statin].
We included studies of patients with and without a diagnosis of coronary
Results
Table 1 shows details of the studies in the meta-analysis, which included data on 376,162 patients (mean age 64 years, 49% were male). Eleven studies were on patients without a history of coronary heart disease (eg, patients being treated for hypertension) who were receiving drugs for the primary prevention of coronary heart disease, and 9 studies were on patients with a diagnosis of coronary heart disease (eg, after a myocardial infarction) who were receiving drugs for the secondary prevention
Discussion
The results of this analysis show that approximately two thirds of patients with a history of coronary heart disease adhere to drugs prescribed to prevent a second coronary heart disease event and approximately half of those without coronary heart disease adhere to drugs prescribed to prevent a first event.
Previous reviews on adherence to cardiovascular preventive treatments were descriptive and did not combine results within or across studies to provide a quantitative summary of effect.31, 32
Conclusions
Our results show that approximately one third of patients who have had a myocardial infarction and approximately one half of those who have not had a myocardial infarction do not adhere to effective cardiovascular preventive treatment long-term. Adherence is not greatly dependent on the class of drug prescribed, suggesting that interventions to improve adherence need to be broadly applied.
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Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and played a role in writing this manuscript.