Low Medication Adherence After Myocardial Infarction

Medication adherence after myocardial infarction low in elderly patients with kidney dysfunction

FRIDAY, Jan. 14 (HealthDay News) -- Long-term adherence to medications following myocardial infarction (MI) in elderly patients is poor, and it is significantly worse among those with kidney dysfunction, according to a study published online Jan. 13 in the Clinical Journal of the American Society of Nephrology.

Tara I. Chang, M.D., from the Stanford University School of Medicine in Palo Alto, Calif., and colleagues examined long-term adherence to medications in a cohort of 2,103 patients older than 65 who were discharged from the hospital after suffering a MI. Patients were treated with one of the recommended medication classes: angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), β-blockers, and statins. Adherence to these medications was measured by the percentage of days covered for 36 months according to pharmacy refills.

The investigators found that long-term adherence to all three medication classes was poor. On average, patients took their medications for 50 to 60 percent of the 36-month study period. Patients who had baseline kidney dysfunction had significantly lower long-term adherence to ACEI/ARB and β-blockers. Long-term adherence to statins did not vary according to the level of kidney function.

"Future strategies should pay special attention to the elderly with kidney dysfunction because this population may be especially vulnerable to poor long-term medication adherence and its adverse consequences," the authors write.

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