Initiation and maintenance of statins and aspirin after acute coronary syndromes (ANZACS-QI 11).
Autor: | Kerr, Andrew J., Turaga, Mansi, Grey, Corina, Lee, Mildred, McLachlan, Andrew, Devlin, Gerry |
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Předmět: |
ASPIRIN
STATINS (Cardiovascular agents) DISEASE relapse prevention CHI-squared test DATABASE management REPORTING of diseases DRUGS FISHER exact test INDIGENOUS peoples LONGITUDINAL method PATIENT compliance RACE REGRESSION analysis RESEARCH funding LOGISTIC regression analysis TREATMENT duration DATA analysis software ACUTE coronary syndrome ODDS ratio |
Zdroj: | Journal of Primary Health Care; Sep2016, Vol. 8 Issue 3, p238-249, 12p |
Abstrakt: | INTRODUCTION: Prior New Zealand studies suggest that only approximately two-thirds of patients who present with an acute coronary syndrome (ACS) are maintained on a statin/aspirin post-discharge. This could be due to sub-optimal initiation or poor longer-term adherence. AIM: To identify the pattern of statin/aspirin maintenance following ACS from initial prescription to 3 years post-discharge. METHODS: All New Zealand Acute Coronary Syndrome Quality Improvement (ANZACS-QI) registry data for consecutive New Zealand residents (2007-2011), who were hospitalised with ACS, were anonymously linked to national datasets to derive a medication possession ratio (MPR) to assess medication maintenance. An MPR ⩾ 0.8 is considered adequate maintenance. RESULTS: Of the 1846 patients discharged alive, 95% were prescribed a statin at discharge and 92% were dispensed a statin within 3 months, but only 75% had a MPR ⩾ 0.8 in the first year, and 67% in year 3. In the same cohort, 98% were prescribed aspirin and 88% were dispensed aspirin within the 3 months of discharge. In the first year, 72% had an aspirin MPR ⩾ 0.8 and 71% maintained this in year 3. Fifty-nine percent were maintained on both aspirin and a statin in the third year, but 20% were maintained on neither. Regression analysis identified the independent predictors of inadequate maintenance in the third year as age < 45 years, no prior statin, and Mā ori and Pacific ethnicity. CONCLUSION: Longer-term maintenance of evidenced-based secondary prevention medications after ACS is suboptimal despite high levels of initial prescribing and dispensing. Understanding the barriers to longer-term maintenance is required to improve patient outcomes. [ABSTRACT FROM AUTHOR] |
Databáze: | Complementary Index |
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