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Medication adherance statin

Richard A Hansen, Natalie Hohmann, Matthew L Maciejewski, Marisa E Domino, Neepa Ray, Nirosha Mahendraratnam, Joel F Farley
Objectives: Adults with schizophrenia and cardiometabolic conditions may be good candidates for co-management by primary care prescribers and specialists. Associated risks for discontinuity in medication management have not been well-studied. This study examines whether medication adherence, inpatient admissions, and emergency department (ED) visits vary by the number and types of prescribers seen by adults with schizophrenia and cardiometabolic conditions. Methods: This study used a retrospective cohort of 4,223 adult Medicaid enrollees with schizophrenia and hypertension, hyperlipidemia, and/or diabetes from three states in 2009-2010...
March 2018: Journal of Pharmaceutical Health Services Research
Judd B Kessler, Andrea B Troxel, David A Asch, Shivan J Mehta, Noora Marcus, Raymond Lim, Jingsan Zhu, William Shrank, Troyen Brennan, Kevin G Volpp
BACKGROUND: Poor medication adherence is common and limits the effectiveness of treatment. OBJECTIVE: To investigate how social supports, automated alerts, and their combination improve medication adherence. DESIGN: Four-arm, randomized clinical trial with a 6-month intervention. PARTICIPANTS: A total of 179 CVS health employees or adult dependents with CVS Caremark prescription coverage, a current daily statin prescription, a medication possession ratio less than 80%, and Internet access...
March 15, 2018: Journal of General Internal Medicine
Fred Stephen Sarfo, Osei Sarfo-Kantanka, Sheila Adamu, Vida Obese, Jennifer Voeks, Raelle Tagge, Vipin Sethi, Bruce Ovbiagele
BACKGROUND: There is an unprecedented rise in the prevalence of stroke in sub-Saharan Africa (SSA). Secondary prevention guidelines recommend that antihypertensive, statin and antiplatelet therapy be initiated promptly after ischemic stroke and adhered to in a persistent fashion to achieve optimal vascular-risk reduction. However, these goals are seldom realized in routine clinical care settings in SSA due to logistical challenges. We seek to assess whether a polypill containing fixed doses of three antihypertensive agents, a statin and antiplatelet therapy taken once daily per os for 12 months among recent stroke survivors would result in carotid intimal thickness regression compared with usual care (UC)...
March 14, 2018: Trials
Barbara Guerard, Vincent Omachonu, Blake Perez, Bisakha Sen
The issue of medication nonadherence has generated significant interest because of its complexity from both cost and outcomes perspectives. Of the 3.2 billion prescriptions written annually in the United States, estimates indicate that half are not taken as prescribed, especially among patients with asymptomatic chronic conditions. The objective of this study was to assess whether a comprehensive wellness assessment (CWA) program helps improve medication adherence for oral diabetic medications, statins, and angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers (ACE/ARBs) in a Medicare Advantage (MA) plan diabetic population...
March 2018: Journal of Healthcare Management / American College of Healthcare Executives
Maria Giner-Soriano, Gerard Sotorra Figuerola, Jordi Cortés, Helena Pera Pujadas, Ana Garcia-Sangenis, Rosa Morros
BACKGROUND: Cardiovascular disease (CVD) is a group of disorders of the heart and blood vessels, such as coronary heart disease (CHD), cerebrovascular disease, and peripheral artery disease. CVD is the leading threat to global health, whether measured by mortality, morbidity, or economic cost. Long-term administration of aspirin, statins, beta-blockers, and angiotensin-converting enzyme inhibitors or angiotensin-receptor blockers improves survival in patients with stablished coronary heart disease...
March 9, 2018: JMIR Research Protocols
B Wilkins, S Hullikunte, M Simmonds, A Sasse, P D Larsen, S A Harding
BACKGROUND: We assessed the effect of a pre-discharge medication checklist on discharge prescription rates of guideline recommended medications following myocardial infarction. In addition, we assessed what proportion of the residual prescribing gap following implementation of the checklist was due to the presence of contraindications. METHODS: We examined baseline prescription rates of guideline recommended medications in 100 patients discharged from our institution following acute myocardial infarction...
November 14, 2017: Heart, Lung & Circulation
Oliver T Mytton, Christopher Jackson, Arno Steinacher, Anna Goodman, Claudia Langenberg, Simon Griffin, Nick Wareham, James Woodcock
BACKGROUND: The National Health Service (NHS) Health Check programme was introduced in 2009 in England to systematically assess all adults in midlife for cardiovascular disease risk factors. However, its current benefit and impact on health inequalities are unknown. It is also unclear whether feasible changes in how it is delivered could result in increased benefits. It is one of the first such programmes in the world. We sought to estimate the health benefits and effect on inequalities of the current NHS Health Check programme and the impact of making feasible changes to its implementation...
March 2018: PLoS Medicine
Brenda Barnes, Ana L Hincapie, Heidi Luder, James Kirby, Stacey Frede, Pamela C Heaton
OBJECTIVES: To compare the effects of 3 different appointment-based model (ABM) designs on medication adherence and medication use outcomes controlling for patient and pharmacy characteristics. METHODS: This study was a retrospective cohort analysis in a large grocery store chain from January 1, 2012, to October 31, 2015. A total of 500 comparison and 613 intervention patients in 3 different model designs were analyzed. The outcome measures were proportion of days covered for selected medication classes, number of fills, administered vaccinations, number of trips, statin use in persons with diabetes, use of high-risk medications in older adults, and medication therapy for persons with asthma...
March 2018: Journal of the American Pharmacists Association: JAPhA
J Liu, W Wang, J Liu, Y Wang, Y Qi, J Y Sun, D Zhao
Objective: To evaluate the impact of different intervention models on adherence to secondary prevention therapies in patients with acute coronary syndrome (ACS). Methods: This multi-center cross-sectional study collected data from 34 hospitals covering 22 provinces in China. Hospitals were randomly divided into four groups: control group(routine treatment and care), promotional calendar group (routine treatment and care plus giving propaganda desk calendar to patients), education group (routine treatment and care add patients education by nurses) and combined intervention group (promotional calendar and education)...
February 24, 2018: Zhonghua Xin Xue Guan Bing za Zhi
Jessica M Franklin, Chandrasekar Gopalakrishnan, Alexis A Krumme, Karandeep Singh, James R Rogers, Joe Kimura, Caroline McKay, Newell E McElwee, Niteesh K Choudhry
BACKGROUND: Healthcare providers are increasingly encouraged to improve their patients' adherence to chronic disease medications. Prediction of adherence can identify patients in need of intervention, but most prediction efforts have focused on claims data, which may be unavailable to providers. Electronic health records (EHR) are readily available and may provide richer information with which to predict adherence than is currently available through claims. METHODS: In a linked database of complete Medicare Advantage claims and comprehensive EHR from a multi-specialty outpatient practice, we identified patients who filled a prescription for a statin, antihypertensive, or oral antidiabetic during 2011 to 2012...
March 2018: American Heart Journal
Vicki Fung, Ilana Graetz, Mary Reed, Marc G Jaffe
BACKGROUND: Patient reports of their adherence behaviors, concerns about statins, and perceptions of atherosclerotic cardiovascular disease (ASCVD) risk could inform approaches for improving adherence to statin therapy. We examined these factors and their associations with adherence. METHODS: We conducted telephone interviews among a stratified random sample of adults receiving statins within an integrated delivery system (N = 730, 81% response rate) in 2010. We sampled equal numbers of individuals in three clinical risk categories: those with 1) coronary artery disease; 2) diabetes or other ASCVD diagnosis; and 3) no diabetes or ASCVD diagnoses...
2018: PloS One
Anna Kańtoch, Barbara Gryglewska, Jadwiga Wójkowska-Mach, Piotr Heczko, Tomasz Grodzicki
BACKGROUND: The prevalence of cardiovascular diseases among nursing home residents is high but little is known whether pharmacologic therapy recommended by actual medication guidelines is followed by facility's staff. AIM: To evaluate the adherence to actual guidelines for treatment of cardiovascular diseases among older adult residents of long-term care (LTC) facilities. MATERIAL AND METHODS: The cross-sectional study was performed from December 2009 to November 2010 among 189 elderly residents aged ≥60 years in 3 LTC facilities in Poland: 1 long-term care hospital (LTCH) and 2 nursing homes (NHs)...
February 2, 2018: Journal of the American Medical Directors Association
Sietse Wieringa, Eivind Engebretsen, Kristin Heggen, Trisha Greenhalgh
BACKGROUND: As a response to the criticisms evidence-based practice currently faces, groups of health care researchers and guideline makers have started to call for the appraisal and inclusion of different kinds of knowledge in guideline production (other than randomized controlled trials [RCTs]) to better link with the informal knowledge used in clinical practice. In an ethnographic study, Gabbay and Le May showed that clinicians in everyday practice situations do not explicitly or consciously use guidelines...
February 2, 2018: Journal of Medical Internet Research
Vanessa Selak, Ruth Webster
International guidelines recommend blood pressure-lowering therapy, statins and aspirin for people who have had a cardiovascular event but use of these medications is low, particularly for lower income countries. Clinical trials have demonstrated that combining these medications into a single pill or capsule (a 'polypill') improves adherence, systolic blood pressure and low density lipoprotein cholesterol compared with usual care in secondary prevention. Uptake of polypill-based care has been underwhelming, possibly due to safety concerns...
February 2018: Therapeutic Advances in Drug Safety
Robin Mathews, William Wang, Lisa A Kaltenbach, Laine Thomas, Rashmee U Shah, Murtuza Ali, Eric D Peterson, Tracy Y Wang
Background -Medication adherence is important to improve long-term outcomes after acute myocardial infarction (MI). We hypothesized that there is significant variation among United States (U.S.) hospitals in terms of post-MI medication adherence, and that patients treated at hospitals with higher post-MI medication adherence will have better long-term cardiovascular outcomes. Methods -We identified 19,704 Medicare patients discharged after acute MI from 347 U.S. hospitals participating in the Acute Coronary Treatment and Intervention Outcomes Network Registry-Get With The Guidelines (ACTION Registry-GWTG) from 1/2/2007 to 10/1/2010...
January 31, 2018: Circulation
Richard Ofori-Asenso, Avtar Jakhu, Andrea J Curtis, Ella Zomer, Manoj Gambhir, Maarit Jaana Korhonen, Mark Nelson, Andrew Tonkin, Danny Liew, Sophia Zoungas
Background: Older individuals (aged ≥65 years) are commonly prescribed statins but may experience a range of barriers in adhering to therapy. The factors associated with poor statin adherence and/or discontinuation among this population have not been comprehensively reviewed. Methods: We conducted a systematic review to identify English articles published through December 12, 2016 that reported factors associated with nonadherence and/or discontinuation of statins among older persons...
January 19, 2018: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
Nathan K Itoga, Hataka R Minami, Meenadachi Chelvakumar, Keon Pearson, Matthew M Mell, Eran Bendavid, Douglas K Owens
Screening for asymptomatic peripheral artery disease (aPAD) with the ankle-brachial index (ABI) test is hypothesized to reduce disease progression and cardiovascular (CV) events by identifying individuals who may benefit from early initiation of medical therapy. Using a Markov model, we evaluated the cost effectiveness of initiating medical therapy (e.g. statin and ACE-inhibitor) after a positive ankle-brachial index (ABI) screen in 65-year-old patients. We modeled progression to symptomatic PAD (sPAD) and CV events with and without ABI screening, evaluating differences in costs and quality-adjusted life years (QALYs)...
January 1, 2018: Vascular Medicine
Ken Lee Chin, Marina Skiba, Christopher M Reid, Andrew Tonkin, Ingrid Hopper, Justin A Mariani, Danny Liew
PURPOSE: Previous studies on the 'treatment gap' in patients with heart failure (HF) have focused either on prescribing or patients' adherence to prescribed treatment. This study sought to determine whether or not recent initiatives to close the gap have also minimised any mismatches between physicians' expectation of their patients' medications, medications in the patients' possession and their actual medication use. METHODS: A cross-sectional observational survey was conducted from December 2015 to June 2016 in The Alfred Hospital HF clinic in Melbourne, Australia...
January 9, 2018: Cardiovascular Drugs and Therapy
Sundeep Chaudhry, Ross Arena, Deepak L Bhatt, Subodh Verma, Naresh Kumar
PURPOSE OF REVIEW: There is growing clinical interest for the use of cardiopulmonary exercise testing (CPET) to evaluate patients with or suspected coronary artery disease (CAD). With mounting evidence, this concise review with relevant teaching cases helps to illustrate how to integrate CPET data into real world patient care. RECENT FINDINGS: CPET provides a novel and purely physiological basis to identify cardiac dysfunction in symptomatic patients with both obstructive-CAD and nonobstructive-CAD (NO-CAD)...
March 2018: Current Opinion in Cardiology
Cem Haymana, Hamza Berlik, Yalçın Güneş, Orhan Enes Tunçez, Cihat Aytekin, Zafer Tapıkara, Hüseyin Güzel, Özlem Öztürk, Cem Barçın, Taner Özgürtaş, Ömer Azal, Alper Sönmez
OBJECTIVE: Familial hypercholesterolemia (FH) is a life-threatening genetic disease associated with elevated low-density lipoprotein cholesterol (LDL-C) and premature coronary heart disease that is undiagnosed and undertreated around the world. This study aimed to examine the demographic characteristics, awareness, and treatment adherence of undiagnosed or undertreated FH patients based on laboratory records. METHODS: In a 16-month retrospective survey using laboratory records, patients with elevated LDL-C (>250 mg/dL) were identified (n=395)...
December 2017: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
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