Purpose of Review
Non-adherence to medications for the secondary prevention of myocardial infarction (MI) is a major contributor to morbidity and mortality in these patients. This review describes recent advances in promoting adherence to therapies for coronary artery disease (CAD).
Recent Findings
Two large randomized controlled trials to “incentivize” adherence were somewhat disappointing; neither financial incentives nor “peer pressure” successfully increased rates of adherence in the post-MI population. Patient education and provider engagement appear to be critical aspects of improving adherence to CAD therapies, where the provider is a physician, pharmacist, or nurse and follow-up is performed in person or by telephone. Fixed-dose combinations of CAD medications, formulated as a so-called “polypill,” have shown some early efficacy in increasing adherence. Technological advances that automate monitoring and/or encouragement of adherence are promising but seem universally dependent on patient engagement. For example, medication reminders via text message perform better if patients are required to respond. Multifaceted interventions, in which these and other interventions are combined together, appear to be most effective.
Summary
There are several available types of proven interventions through which providers, and the health system at large, can advance patient adherence to CAD therapies. No single intervention to promote adherence will be successful in all patients. Further study of multifaceted interventions and the interactions between different interventions will be important to advancing the field. The goal is a learning healthcare system in which a network of interventions responds and adapts to patients’ needs over time.
Purpose
To evaluate the presence of sex-specific analysis (SSA) in abstracts accepted for podium presentation at the Arthroscopy Association of North America (AANA) and American Orthopaedic Society for Sports Medicine (AOSSM) annual meetings from 2016 to 2019.
Methods
Abstracts accepted for podium presentation at the AANA and AOSSM annual meetings from 2016 to 2019 were selected for review. Studies that included sex as a variable in a multifactorial statistical model were considered to have performed adequate SSA. Secondary data collected included whether the abstract had a female lead or senior author, the degrees of the female authors, and the anatomic focuses of studies with SSA.
Results
Of the 891 total abstracts accepted for podium presentation at the AANA and AOSSM annual meetings from 2016 to 2019, 90 (10%) included SSA. There were 284 AANA abstracts, 24 (8%) of which reported SSA. Of the 607 AOSSM abstracts, 66 (11%) reported SSA. There were 43 female first authors (15%) and 33 female senior authors (12%) of the AANA abstracts compared with 92 female first authors (15%) and 39 female senior authors (6%) of the AOSSM abstracts. Of the 891 total abstracts, 135 (15%) listed a female lead author and 72 (8%) had a female senior author. Of the 135 female first authors, 92 (68%) had an M.D., whereas 40 of the 72 female senior authors (56%) had an M.D. Analysis of all abstracts combined showed a positive correlation between SSA and a female first author (Pearson correlation coefficient = 0.035,
P
= .147), as well as between SSA and a female senior author (Pearson correlation coefficient = 0.052,
P
= .059).
Conclusions
From 2016 to 2019, only 10% of abstracts accepted for podium presentation at the AANA and AOSSM annual meetings included SSA. Altogether, women represented 15% of first authors and 8% of senior authors.
Clinical Relevance
This study highlights the low percentage of SSA in abstracts presented at the AANA and AOSSM annual meetings from 2016 to 2019. Future studies should attempt to perform SSA when relevant to better evaluate differences in outcomes between male and female patients.
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