838-4 National evaluation of long-term adherence to beta-blocker therapy after acute myocardial infarction in patients with commercial health insurance

Impact of Medication Therapy Discontinuation on Mortality After Myocardial Infarction

“…8 Among patients with insurance in a national study, 45% of patients discharged with ␤-blocker prescriptions were no longer taking the medication 3 months after hospital discharge for MI. 13 Rates of medication therapy discontinuation in our study were consistent with prior findings; however, we found that medication therapy discontinuation occurred much earlier than previously reported, and we linked medication therapy discontinuation to increased mortality risk. These findings suggest that the transition period from hospital discharge to the outpatient setting is a critical period to ensure that patients continue to take medications that improve outcomes after MI.…”

Medication adherence in heart failure

“…In a multi-center analysis of medical records of continuously enrolled beneficiaries in 2001, data from 11 health plans suggested that medication adherence rates (defined as prescription claims covering ‡75% of days) following myocardial infarction (MI) were only 52% at 6 months and 45% at 12 months ( Fig. 1) [67]. Eagle and colleagues found that between 8% and 20% of patients following hospitalization for MI or unstable angina were no longer taking medication at 6 months [68].…”

Interpreting the COURAGE trial. PCI is no better than medical therapy for stable angina? Seeing is not believing.

“…27 Similarly, data from managed care organizations suggest that as few as 46% of patients remain compliant with beta-blocker therapy at 1 year after an MI. 28 An international registry recently reported that 30% of patients with documented symptomatic coronary artery disease received no lipidlowering therapy and that compliance with guideline-recommended therapies was significantly greater in patients with prior revascularization. 29 Although 70% of COURAGE patients achieved a low-density lipoprotein cholesterol (LDL-C) level lower than 85 mg/dL, fewer than 50% of patients in CRU-SADE achieved an LDL-C level lower than 100 mg/dL.…”