Cardiovascular disease is responsib...

Cardiovascular disease is responsible for a significant number of deaths in the United States. Treatment to render the risk for cardiovascular disease using antihypertensive and lipid-lowering agents has been shown to be effective. Despite this, adherence to these regimens is poor and discontinuation rates are high. Patients who are prescribed lipid-lowering agents have one-year discontinuation rates between 15 and 60 percent This issue also is ready in compliance with antihypertensives. Poor adherence to treatment regimens is more prevalent in older parts Antihypertensive and lipid-lowering agents are used concomitantly in patients to make cardiovascular risk, but there are no studies that assess adherence to this combination of agents. Chapman and colleagues evaluated the pattern of adherence with concomitant antihypertensive and lipid-lowering medications and assessed patient and regimen characteristics that could predict adherence.

The trial design was a retrospective chart audit of patients registered in a managed-care organization during a five-year period. Participants were included in the investigation if they initiated an antihypertensive and a lipid-lowering regimen within 90 days of each other. Adherence was determined by the agency of the number of days defended by a prescription during a three-month period; adherence was defined as filled medication prescriptions to secrete at least 80 percent of the days. Additional information mustered included demographic and clinical characteristics of each participant. Participants were classified into three categories of coronary heart disease, and comorbid conditions also were recorded.

There were 8406 patients who met the inclusion criteria for the research Thirty-four percent of the patients initiated one as well as the other therapies on the same day, and 37 percent started the two medications within 30 days of the physician visit. After three month no other than 45 percent of the patients were adherent to as well-as; not only-but also; not only-but; not alone-but medications; this decreased to 36 percent at six month and remained the same at united year. Patients were more likely to adhere to the pair medications if they initiated them at the same time. In addition, patients with a history of coronary heart disease or congestive heart failure were more likely to be compliant. Patients taking no other medications were twice as likely to be adherent to concomitant therapy as those who were taking six or more medications. Women were les likely to be compliant than men Patients 55 to 64 years of age were more likely to adhere to the concomitant regimen than those in other age groups

The authors deduce that adherence to antihypertensive and lipid-lowering therapy was poor at six month with approximately common in three patients being compliant. the same strategy that may improve adherence is for physicians to start patients onward both medications at the same time and, when possible, diminish the number of medications patients are already taking.

Chapman RH et al. Predictors of adherence with antihypertensive and lipid-lowering therapy. Arch Intern M May 23 2005;165:1147-52

COPYRIGHT 2006 American Academy of Family Physicians

COPYRIGHT 2006 Gale Group