Does a cardiovascular event change adherence to statin treatment in patients with type 2 diabetes? A matched cohort design

Abstract

The occurrence of a drug-treated cardiovascular event appeared to avert the declining statin adherence rate observed in diabetes patients without such an event. On the other hand, one in five patients became less adherent after the event, indicating that there are still important benefits to achieve.

Changes in Statin Adherence Following an Acute Myocardial Infarction Among Older Adults: Patient Predictors and the Association With Follow‐Up With Primary Care Providers and/or Cardiologists

“…They also found that patients with a greater baseline comorbidity burden were less likely to change from nonadherent to adherent and were more likely to change from adherent to nonadherent after an AMI. Another study with 855 patients with type 2 diabetes mellitus found that 26% of patients became more adherent and 20% of patients became less adherent after incident cardiovascular events . However, we found strong relationships with adherence change after AMI associated with race/ethnicity and CABG during hospitalization that were not found in these earlier studies.…”

“…Change in adherence to statins after an AMI has been reported in a few prior studies . In a study that used a 5% random sample of Medicare patients, Kronish et al found that 33% of patients with pre‐AMI PDC ≥80% became nonadherent after an AMI, while 38% of patients with PDC <80% became adherent after AMI.…”

“…In order to effectively develop clinical and policy interventions to improve adherence to secondary prevention therapies, it is important to understand how medication adherence may change in response to an AMI, which patients are more likely to have increased or decreased adherence, and how follow‐up with healthcare providers may affect this change. The evidence available from prior studies is insufficient to address these questions . Therefore, the aims of this study were (1) to determine to what extent older patients’ adherence to statins may change after an AMI, (2) to identify patient characteristics associated with change in statin adherence after an AMI, and (3) to assess whether post‐discharge follow‐up with PCPs and/or cardiologists is associated with change in statin adherence after an AMI.…”

Impact of Hospitalization for Acute Myocardial Infarction on Adherence to Statins Among Older Adults

“…While several studies have shown that health events, such as cancer diagnosis, pregnancy, or AMI, can increase smoking cessation,(2,33) there are few data showing that health events can positively influence medication adherence. (19) Several small studies show that clinicians can enhance the effect of the teachable moment by drawing clear connections between the health event and preventive health behaviors when counseling patients. (34,35) Thus, our study implies that clinicians can promote statin adherence after AMI by explicitly linking the prevention of recurrent cardiac events to medication adherence.…”

“…(12–15) Previous studies have documented substantial nonadherence to statins after hospitalization for AMI,(16–18) but few data have been published on changes in adherence to statins from before to after an AMI hospitalization. (19) Determining the impact of an AMI hospitalization on adherence to statins after discharge can guide clinical expectations of statin adherence and can inform the design of interventions to improve adherence.…”