Adherence to guidelines for pharmacological treatment of young adults with myocardial infarction in Poland: Data from Polish Registry of Acute Coronary Syndromes (PL‐ACS)

Abstract

Summary What is known and objective Myocardial infarction (MI) in young adults accounts for up to 10% of all cases. Regarding life expectancy and professional activity, it is extremely important to restore and maintain young patients’ full performance. Therefore, secondary prevention is especially vital in this group of patients. The paper focuses on the analysis of pharmacotherapy in young MI patients in Poland, assessing disparities between the European Society of Cardiology guidelines and clinical practice, and regional differences among the provinces. Methods The analysis was conducted using the data from a nationwide, observational, multicentre, prospective study—the Polish Registry of Acute Coronary Syndromes (PL‐ACS). The data were collected from patients ≤45 years old with MI who were hospitalized in the period 2010‐2014. Results and discussion A retrospective study included 6367 MI patients. They constituted 3.9% of all the patients with MI in Poland. Despite the fact that during hospitalization regional differences were observed in case of acetylsalicylic acid (range 70.3%‐93.8%), β‐blockers (range 50.0%‐79.6%), statins (range 53.4%‐85.7%) and angiotensin‐converting enzyme inhibitors (range 46.9%‐75.0%), the majority of patients received the drugs according to the guidelines. Regional differences found at discharge also regarded those medications, but the range of observed variations was smaller. On average, three‐quarter of patients received guideline‐recommended medications. Still, in some provinces, almost a quarter of patients were administered those medications only at discharge. What is new and conclusion In the study population, there were significant differences between the provinces regarding pharmacotherapy during hospitalization, which concerned major groups of medications. However, pharmacotherapy indicated at discharge revealed fewer regional differences and adhered to guideline recommendations to a greater extent. Nevertheless, there is still some room for improvement, especially with regard to pharmacotherapy during hospitalization.

Drug compliance and the Morisky Adherence Scale: An expression of concern and a warning

“…Measuring adherence is just one, albeit important, way of probing how the impact of medications could be optimized, not only at the individual level but also at the population level 10–13 . A useful flipside of this has been the study of the extent to which medications are prescribed appropriately 14 and tools for measuring this are important 15 .…”