Post-heart attack, patients with lower kidney function not taking prescribed meds

Jan 13, 2011

Among older adults with a recent heart attack (myocardial infarction), those with lower levels of kidney function are less likely to take their medications as prescribed, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society of Nephrology (CJASN).

"Several types of medications have proven benefit for preventing recurrent heart attacks, yet only about half of people with heart disease take their medications correctly," comments Wolfgang C. Winkelmayer, MD, ScD (Stanford University School of Medicine, Palo Alto, CA). "Adherence was lower in patients with more pronounced kidney dysfunction."

The researchers studied 2,103 patients aged 65 or older with a recent . Pharmacy insurance claims records were used to determine the percentage of days that patients actually had their prescribed medications.

The results showed low long-term adherence rates for three major classes of heart medications: angiotensin-converting enzyme inhibitors/angiotensin-receptor blockers (ACEIs/ARBs), beta-blockers, and statin drugs. Over three years' follow-up, the patients had their prescribed drugs for only 50 to 60 percent of the time.

For ACEIs/ARBs and beta-blockers, medication adherence was significantly lower for patients who had lower levels of kidney function at the beginning of the study. Adherence to statin drugs was not significantly related to kidney function.

"Since poor medication adherence increases the risk of hospitalization and death, it is important to understand the scope of the problem," Winkelmayer explains. In a previous study in the same group of patients, the researchers found low medication adherence rates within the first 90 days after heart attack. "In the current study, we wanted to extend these findings to examine long-term outpatient medication adherence, particularly in patients with kidney dysfunction, who are at high risk for recurrent heart attacks but who have not been studied extensively to date." "Future strategies to improve medication adherence and clinical outcomes will need to pay special attention to this high-risk population."

The study had some important limitations. Kidney function was measured based on a single lab test performed in the hospital, which may underestimate the true baseline . The study included a sample of elderly, low-income patients with a high proportion of whites and women, so the results may not be applicable to a more diverse population. Also, since was measured using insurance claims data, the researchers were unable to determine why patients weren't following their prescriptions. "For example, the medication may have been purposely discontinued by the treating physician due to unwanted side effects," says Winkelmayer.

Explore further: CDC charges Johns Hopkins to lead development of Ebola training module

add to favorites email to friend print save as pdf

Related Stories

Researchers fight America's 'other drug problem'

Nov 17, 2010

Medications do not have a chance to fight health problems if they are taken improperly or not taken at all. Non-adherence to medications costs thousands of lives and billions of dollars each year in the United ...

Irregular medication use puts seniors at risk for falling

May 19, 2010

Older adults increase their chances of falling by not taking their medications as directed, according to an article in the latest edition of the Journals of Gerontology Series A: Biological and Medical Sciences (Volume 65A, N ...

Recommended for you

Study reveals state of crisis in Canadian foster care system

18 hours ago

A new study of foster care in Canada led by a researcher at Western University reveals a shrinking number of foster care providers are available across the country to care for a growing number of children with increasingly ...

Researchers prove the benefits of persimmons for diet

20 hours ago

Alba Mir and Ana Domingo, researchers from the Department of Analytical Chemistry of the University of Valencia, under the supervision of professors Miguel de la Guardia and Maria Luisa Cervera, from the same department, ...

Hand blenders used for cooking can emit persistent chemicals

20 hours ago

Eight out of twelve tested models of hand blenders are leaking chlorinated paraffins when used according to the suppliers' instructions. This is revealed in a report from Stockholm University where researchers analyzed a ...

User comments : 0