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GW24-e3018 Long-term Medication Adherence Following Acute Coronary Syndrome in Patients with and without Recurrent Cardiovascular Events: Analysis of the HealthCore Integrated Research Database 2006–2011
  1. Vanessa S Reddy1,
  2. Rakesh Luthra2,
  3. Yaping Xu1,
  4. Maxine Fisher2,
  5. Thomas Power3,
  6. Ken Wilhelm1,
  7. Mark Cziraky2
  1. 1Genentech Inc., South San Francisco, California, USA
  2. 2HealthCore Inc., Wilmington, Delaware, USA
  3. 3AIM Specialty Health, Deerfield, Illinois, USA

Abstract

Objectives Medication adherence is critical for the management of chronic disorders such as cardiovascular disease. However, long-term adherence has not been well described in acute coronary syndrome patients. The aim of this study is to assess long-term medication adherence to guideline-recommended treatments following acute coronary syndrome in patients with and without recurrent cardiovascular events.

Methods Acute coronary syndrome patients hospitalised with an ICD-9 code for acute myocardial infarction or unstable angina were identified from the HealthCore Integrated Research Database (HIRDSM) between January 2006 and September 2011. Mean medication possession ratios for guideline-recommended acute coronary syndrome treatments were assessed 1 and 3 years after the index acute coronary syndrome using pharmacy claims data, stratified by presence or absence of recurrent cardiovascular events, defined as stroke, myocardial infarction or coronary heart disease-related mortality.

Results Of the 140,903 acute coronary syndrome patients identified, 22% had > 1 recurrent cardiovascular event and were on average older (72.4 versus 65.2 years), included more women (44.5 versus 40.6%), and had more comorbidities (e.g. diabetes mellitus 49.7 versus 39.7%) as compared to those without recurrent events. After 3 years, patients were most adherent to antihypertensives (medication possession ratio = 0.70). The medication possession ratio ranged from 0.53 to 0.70 among different guideline-recommended treatments for patients with acute coronary syndrome. Overall, differences in medication possession ratios in patients with versus without recurrent events were small, although some were statistically significant.

Conclusions At 3 years, medication adherence was highest to antihypertensives. The gaps in adherence highlight the need to encourage and monitor treatment use following acute coronary syndrome, as well as understand class-specific adherence barriers, to improve long-term outcomes.

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