Journal article
Reasons for discontinuation of recommended therapies according to the patients after acute coronary syndromes.
- Gencer B Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland.
- Rodondi N Department of General Internal Medicine, University of Bern, Bern, Switzerland. Electronic address: Nicolas.Rodondi@insel.ch.
- Auer R Department of Ambulatory and Community Medicine, University of Lausanne, Lausanne, Switzerland.
- Räber L Department of Cardiology, Bern University Hospital, Bern, Switzerland.
- Klingenberg R Department of Cardiology, Zürich University Hospital, Zürich, Switzerland.
- Nanchen D Department of Ambulatory and Community Medicine, University of Lausanne, Lausanne, Switzerland.
- Carballo D Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland.
- Vogt P Division of Cardiology, Lausanne University Hospital, Lausanne, Switzerland.
- Carballo S Department of Medicine, Geneva University Hospitals, Geneva, Switzerland.
- Meyer P Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland.
- Matter CM Department of Cardiology, Zürich University Hospital, Zürich, Switzerland.
- Windecker S Department of Cardiology, Bern University Hospital, Bern, Switzerland.
- Lüscher TF Department of Cardiology, Zürich University Hospital, Zürich, Switzerland.
- Mach F Division of Cardiology, Geneva University Hospitals, Geneva, Switzerland.
- 2015-01-14
Published in:
- European journal of internal medicine. - 2015
Acute coronary syndromes
Outcomes research
Secondary prevention
Acute Coronary Syndrome
Adrenergic beta-Antagonists
Aged
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Aspirin
Attitude to Health
Cohort Studies
Female
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Male
Medication Adherence
Middle Aged
Platelet Aggregation Inhibitors
Prospective Studies
Purinergic P2Y Receptor Antagonists
English
BACKGROUND
The prescription of recommended medical therapies is a key factor to improve prognosis after acute coronary syndromes (ACS). However, reasons for cardiovascular therapies discontinuation after hospital discharge are poorly reported in previous studies.
METHODS
We enrolled 3055 consecutive patients hospitalized with a main diagnosis of ACS in four Swiss university hospitals with a prospective one-year follow-up. We assessed the self-reported use of recommended therapies and the reasons for medication discontinuation according to the patient interview performed at one-year follow-up.
RESULTS
3014 (99.3%) patients were discharged with aspirin, 2983 (98.4%) with statin, 2464 (81.2%) with beta-blocker, 2738 (90.3%) with ACE inhibitors/ARB and 2597 (100%) with P2Y12 inhibitors if treated with coronary stent. At the one-year follow-up, the discontinuation percentages were 2.9% for aspirin, 6.6% for statin, 11.6% for beta-blocker, 15.1% for ACE inhibitor/ARB and 17.8% for P2Y12 inhibitors. Most patients reported having discontinued their medication based on their physicians' decision: 64 (2.1%) for aspirin, 82 (2.7%) for statin, 212 (8.6%) for beta-blocker, 251 (9.1% for ACE inhibitor/ARB) and 293 (11.4%) for P2Y12 inhibitors, while side effect, perception that medication was unnecessary and medication costs were uncommon reported reasons (<2%) according to the patients.
CONCLUSIONS
Discontinuation of recommended therapies after ACS differs according the class of medication with the lowest percentages for aspirin. According to patients, most stopped their cardiovascular medication based on their physician's decision, while spontaneous discontinuation was infrequent.
The prescription of recommended medical therapies is a key factor to improve prognosis after acute coronary syndromes (ACS). However, reasons for cardiovascular therapies discontinuation after hospital discharge are poorly reported in previous studies.
METHODS
We enrolled 3055 consecutive patients hospitalized with a main diagnosis of ACS in four Swiss university hospitals with a prospective one-year follow-up. We assessed the self-reported use of recommended therapies and the reasons for medication discontinuation according to the patient interview performed at one-year follow-up.
RESULTS
3014 (99.3%) patients were discharged with aspirin, 2983 (98.4%) with statin, 2464 (81.2%) with beta-blocker, 2738 (90.3%) with ACE inhibitors/ARB and 2597 (100%) with P2Y12 inhibitors if treated with coronary stent. At the one-year follow-up, the discontinuation percentages were 2.9% for aspirin, 6.6% for statin, 11.6% for beta-blocker, 15.1% for ACE inhibitor/ARB and 17.8% for P2Y12 inhibitors. Most patients reported having discontinued their medication based on their physicians' decision: 64 (2.1%) for aspirin, 82 (2.7%) for statin, 212 (8.6%) for beta-blocker, 251 (9.1% for ACE inhibitor/ARB) and 293 (11.4%) for P2Y12 inhibitors, while side effect, perception that medication was unnecessary and medication costs were uncommon reported reasons (<2%) according to the patients.
CONCLUSIONS
Discontinuation of recommended therapies after ACS differs according the class of medication with the lowest percentages for aspirin. According to patients, most stopped their cardiovascular medication based on their physician's decision, while spontaneous discontinuation was infrequent.
- Language
-
- English
- Open access status
- closed
- Identifiers
-
- DOI 10.1016/j.ejim.2014.12.014
- PMID 25582072
- Persistent URL
- https://sonar.ch/global/documents/140225
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