Dual antiplatelet therapy after myocardial infarction and percutaneous coronary intervention: analysis of patient adherence using a French health insurance reimbursement database

Latry, Philippe; Martin-Latry, Karin; Lafitte, Marianne; Peter, Claude; Couffinhal, Thierry

doi:10.4244/eijv7i12a221

Cited by 27 publications

(24 citation statements)

References 41 publications

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“…French researchers have estimated the risk of discontinuation of therapy after 1 month, in relation to ASA and after 3 months of clopidogrel treatment, at 18.6%, with an increase to 49.1% after 12 months. It is possible that the adherence-related issues might be a reflection of the well-described phenomena of many patients' resistance to antiplatelet treatment [42]. These results are consistent with the observations of an Italian study where only 54% of patients during a 6-month follow-up visit were determined to be receiving appropriate antiplatelet therapy [43].…”

Section: Adherence After Ami Treated By Pcisupporting

confidence: 81%

Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications

Świeczkowski

Mogielnicki²,

Cwalina

et al. 2013

Cardiol J

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Section: Adherence After Ami Treated By Pcisupporting

confidence: 81%

Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications

Świeczkowski

Mogielnicki²,

Cwalina

et al. 2013

Cardiol J

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“…Evaluation of adherence to treatment by using the proportion of days covered by the treatment, as applied in our study, had already been employed in several previous studies [6,7,18,19]. According to the applied definition (drug availability ≥80%) 54.3% of patients in our study adhered to treatment with clopidogrel.…”

Section: Discussionmentioning

confidence: 99%

“…Several factors related to poor response to clopidogrel should be taken into account including low patient adherence to medication [4,5,6,7]. Self-reported drug intake is the easiest and most frequently used method of assessment of patient adherence to medication.…”

Section: Introductionmentioning

confidence: 99%

Discrepancies in Assessment of Adherence to Antiplatelet Treatment after Myocardial Infarction

Kubica

Kasprzak²,

Obońska³

et al. 2015

Pharmacology

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The poor response to clopidogrel is multifactorial and includes, amongst others, low patient adherence to medication. The aim of this study was to assess the reported patient adherence to treatment with clopidogrel and confront it with adherence assessed by drug availability. We evaluated determinants of adherence and its impact on platelet aggregation and clinical outcome. The study population comprised 184 patients treated with primary percutaneous coronary intervention for acute myocardial infarction. Follow-up visits were scheduled at 3, 6 and 9 months after discharge. Patient adherence to clopidogrel was defined according to self-reported drug intake and verified based on data from the National Health Fund regarding the purchase of prescribed drugs. The patients were judged as adherent when the proportion of drug availability exceeded 80%. According to drug availability, 100 (54.3%) patients were adherent and 84 (45.7%) were nonadherent. The analysis identified the following factors as predictors of low adherence (<80%): adenosine diphosphate-induced platelet aggregation (ADP-PA) during hospitalization ≤45 U, male gender and occurrence of ST-elevation myocardial infarction [(STEMI) vs. non-STEMI (NSTEMI)], while three-vessel disease was predictive of high adherence to medication. Compared with drug availability-based assessment, self-reported drug intake was significantly different: 172 (94.5%) patients reported regular and 10 (5.5%) patients reported irregular intake of clopidogrel. Clinical follow-up suggested that the self-reported nonregular clopidogrel intake may discriminate patients with a high risk of cardiovascular events. We demonstrated a huge discrepancy between the two most widely used methods for the evaluation of adherence to clopidogrel in secondary prevention treatment in patients after STEMI and NSTEMI. ADP-PA during hospitalization ≤45 U, male gender and STEMI (vs. NSTEMI) were independent predictors of nonadherence while three-vessel disease was independently predictive of adherence to treatment with clopidogrel in the investigated population.

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“…Based on the results, <50-year-old patients have an almost universal optimal medication at the time of hospital discharge from PCI. However, in general, 25-60% of patients discontinue optimal discharge medication one year after PCI (16)(17)(18). Moreover, young age in itself is a known predictor of both adverse events as well as poor adherence to secondary prevention (19,20).…”

Section: Discussionmentioning

confidence: 99%

Predictors of permanent work disability among ≤50-year-old patients undergoing percutaneous coronary intervention

Gunn¹,

Kiviniemi²,

Biancari³

et al. 2015

Scand J Work Environ Health

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Dual antiplatelet therapy after myocardial infarction and percutaneous coronary intervention: analysis of patient adherence using a French health insurance reimbursement database

Abstract: These results suggest that while this medication is available to patients, the treatment is often stopped before one year. This may account for what has been reported as "resistance" to antiplatelet therapy described in a subset of patients.

Cited by 27 publications

References 41 publications

Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications

Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications

Discrepancies in Assessment of Adherence to Antiplatelet Treatment after Myocardial Infarction

Predictors of permanent work disability among ≤50-year-old patients undergoing percutaneous coronary intervention

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