Association between Adherence to Secondary Prevention Therapies and Mortality in Acute Myocardial Infarction

• Main Authors: Tzu-ChiLiu, 劉姿祺
• Other Authors: Yea-Huei Kao Yang
• Format: Others
• Language: zh-TW
• Published: 2014
• Online Access: http://ndltd.ncl.edu.tw/handle/v79zfu

碩士 === 國立成功大學 === 臨床藥學與藥物科技研究所 === 102 === Practice guidelines recommend that post-MI patients receive preventive therapies including anti-platelets, beta-blockers, ACEIs/ARBs, and statins, unless contraindicated. Despite the evidence supporting their use, the poor adherence has been documented. The purposes of this study were to assess adherence to secondary prevention therapies and to evaluate the association between medication adherence and mortality following AMI in Taiwan using data from National Health Insurance Research Database (NHIRD). We measured medication adherence by determining the proportion of days covered (PDC) for each therapeutic group in 1 year following hospital discharge. Adherence was classified into three categories—high (PDC 80%), intermediate (40% PDC 〈80%), and low (PDC 〈40%). After calculating the one year PDC, the proportion of highly adherent patients was suboptimal in both STEMI and NSTEMI groups. The association of adherence with mortality estimated by Cox proportional hazards models showed the risk of mortality was higher for low adherers compared with high adherers among the study drugs. Overall, adherence rates for post-MI secondary medications were suboptimal in Taiwan. Patients with lower adherence were at increased mortality risk. Our results indicate that there remains room to improve the use of secondary prevention therapies to AMI patients.