Reasons for discontinuation of recommended therapies according to the patients after acute coronary syndromes.

Gencer, Baris; Rodondi, Nicolas; Auer, Reto; Räber, Lorenz; Klingenberg, Roland; Nanchen, David; Carballo, David; Vogt, Pierre; Carballo, Sebastian; Meyer, Philippe; Matter, Christian M; Windecker, Stephan; Lüscher, Thomas Felix; Mach, François (2015). Reasons for discontinuation of recommended therapies according to the patients after acute coronary syndromes. European journal of internal medicine, 26(1), pp. 56-62. Elsevier 10.1016/j.ejim.2014.12.014

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BACKGROUND The prescription of recommended medical therapies is a key factor to improve prognosis after acute coronary syndromes (ACS). However, reasons for cardiovascular therapies discontinuation after hospital discharge are poorly reported in previous studies. METHODS We enrolled 3055 consecutive patients hospitalized with a main diagnosis of ACS in four Swiss university hospitals with a prospective one-year follow-up. We assessed the self-reported use of recommended therapies and the reasons for medication discontinuation according to the patient interview performed at one-year follow-up. RESULTS 3014 (99.3%) patients were discharged with aspirin, 2983 (98.4%) with statin, 2464 (81.2%) with beta-blocker, 2738 (90.3%) with ACE inhibitors/ARB and 2597 (100%) with P2Y12 inhibitors if treated with coronary stent. At the one-year follow-up, the discontinuation percentages were 2.9% for aspirin, 6.6% for statin, 11.6% for beta-blocker, 15.1% for ACE inhibitor/ARB and 17.8% for P2Y12 inhibitors. Most patients reported having discontinued their medication based on their physicians' decision: 64 (2.1%) for aspirin, 82 (2.7%) for statin, 212 (8.6%) for beta-blocker, 251 (9.1% for ACE inhibitor/ARB) and 293 (11.4%) for P2Y12 inhibitors, while side effect, perception that medication was unnecessary and medication costs were uncommon reported reasons (<2%) according to the patients. CONCLUSIONS Discontinuation of recommended therapies after ACS differs according the class of medication with the lowest percentages for aspirin. According to patients, most stopped their cardiovascular medication based on their physician's decision, while spontaneous discontinuation was infrequent.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Rodondi, Nicolas; Räber, Lorenz and Windecker, Stephan

Subjects:

600 Technology > 610 Medicine & health

ISSN:

0953-6205

Publisher:

Elsevier

Language:

English

Submitter:

Judith Liniger

Date Deposited:

24 Feb 2016 16:31

Last Modified:

24 Feb 2016 16:31

Publisher DOI:

10.1016/j.ejim.2014.12.014

PubMed ID:

25582072

Uncontrolled Keywords:

Acute coronary syndromes; Outcomes research; Secondary prevention

BORIS DOI:

10.7892/boris.75955

URI:

https://boris.unibe.ch/id/eprint/75955

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