Patients often stop taking heart attack drugs


NEW YORK (Reuters Health) - A significant percentage of patients stop taking medications prescribed after a heart attack, despite the fact that these drugs increase their chances of survival, investigators report. They call for a better system for patient follow-up to prevent unnecessary deaths related to non-usage of these drugs.

Dr. P. Michael Ho at Denver Veterans Affairs Medical Center, Colorado, and colleagues conducted a review of 1521 patients enrolled in the Prospective Registry Evaluating Myocardial Infarction: Event and Recovery (PREMIER) study.

Results of the study are published in the Archives of Internal Medicine.

Patients had been discharged from any of 19 participating hospitals after a heart attack between June 2003 and June 2004. The investigators assessed whether or not patients remained on recommended post-MI therapy including aspirin, beta-blockers (Tenormin, Lopressor), and statins Lipitor, Zocor), for at least a month following discharge. The investigators also assessed the impact of drug adherence on 12-month death rates.

"These patients were discharged on all the appropriate medications but for some reason, one in eight stopped taking all of them by 1 month after hospital discharge," Ho told Reuters Health.

Another 4 percent discontinued two of the medications, and 18 percent more dropped one of the drugs.

Risk factors for drug discontinuation included older age and low eduction level.

Patients who discontinued prescribed medications had a 1-year survival of 89 percent compared with a 98-percent survival rate for those who adhered to one or more of the three drugs prescribed at discharge.

"The assessment of medication use should be an integral part of the first post-heart attack outpatient visit," the team recommends. If early in-person follow-up is not possible, "innovative strategies, such as the use of telehealth technologies, should be explored as an alternative."

"From the patient perspective," Ho added, "it would be helpful for them to incorporate taking their medications into their daily routines and to understand the reasons why they are taking each medication."

SOURCE: Archives of Internal Medicine, September 25, 2006.