Assessing overall duration of cardiovascular medicines in veterans with established cardiovascular disease

Roughead, Elizabeth E.; Vitry, Agnès; Preiss, Adrian K.; Barratt, John D.; Gilbert, Andrew L.; Ryan, Philip

doi:10.1097/hjr.0b013e32832f3b56

Cited by 15 publications

(16 citation statements)

References 18 publications

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“…This likely relates to recommendations for these to be used indefinitely . Similarities in the proportion of MI patients taking such preventive medications have been reported previously in a large meta‐analysis …”

Section: Discussionsupporting

confidence: 74%

“…[8][9][10][11] Similarities in the proportion of MI patients taking such preventive medications have been reported previously in a large meta-analysis. 14…”

Section: Individual Preventive Drug Classesmentioning

confidence: 99%

“…Following discharge from hospital, there is limited evidence regarding the long‐term regimen of secondary preventive cardiovascular medications in Australia. One study of 9635 Australian veterans with ischemic heart disease reported high persistence (continuance of the treatment for the prescribed duration) to cardiovascular medications over a 6.5‐year period, particularly for lipid‐lowering drugs, antiplatelets, and ACE i /ARBs . Whether or not these patterns of preventive medication persistence are also present in the broader community is unanswered.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the availability of guidelines [10][11][12][13] and substantial government subsidies for these medications, gaps in prescription and dispensing persist in Australia and elsewhere. [14][15][16][17] In Australia, studies show that even at hospital discharge, a substantial proportion of eligible patients is not prescribed all of the recommended medications. 18,19 A recent bi-national snapshot of 2299 people with confirmed ACS found that only 65% were prescribed sufficient preventive drugs (4-5 of the following: lipid lowering, aspirin, antiplatelet, β-blocker, ACEi/ARB) at discharge.…”

Section: Introductionmentioning

confidence: 99%

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Secondary preventive medication use in a prevalent population‐based cohort of acute coronary syndrome survivors

Gunnell

Hung

Knuiman

et al. 2016

Cardiovascular Therapeutics

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Section: Discussionsupporting

confidence: 74%

“…[8][9][10][11] Similarities in the proportion of MI patients taking such preventive medications have been reported previously in a large meta-analysis. 14…”

Section: Individual Preventive Drug Classesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Secondary preventive medication use in a prevalent population‐based cohort of acute coronary syndrome survivors

Gunnell

Hung

Knuiman

et al. 2016

Cardiovascular Therapeutics

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“…In a random sample of 48 690 Australian long-term health concession card holders on an ACEI, ARB and/or calcium-channel blocker,48 81% of participants who had an initial prescription filled for ACEI or ARB medications had a second prescription filled, and the proportions decreased to approximately 45% and 47%, respectively, for ACEIs and ARBs, after median periods of approximately 2 years. However, in a study of 9635 veterans following a hospitalisation for ischaemic heart disease,49 adherence levels of 75% to ACEI/ARBs (median treatment duration of 5.4 years), 83.9% for lipid-lowering therapies (median duration of 6.2 years) and 84% for non-aspirin antiplatelets (median duration of 5 years) were observed.…”

Section: Discussionmentioning

confidence: 99%

Long-term use and cost-effectiveness of secondary prevention drugs for heart disease in Western Australian seniors (WAMACH): a study protocol

et al. 2014

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IntroductionSecondary prevention drugs for cardiac disease have been demonstrated by clinical trials to be effective in reducing future cardiovascular and mortality events (WAMACH is the Western Australian Medication Adherence and Costs in Heart disease study). Hence, most countries have adopted health policies and guidelines for the use of these drugs, and included them in government subsidised drug lists to encourage their use. However, suboptimal prescribing and non-adherence to these drugs remains a universal problem. Our study will investigate trends in dispensing patterns of drugs for secondary prevention of cardiovascular events and will also identify factors influencing these patterns. It will also assess the clinical and economic consequences of non-adherence and the cost-effectiveness of using these drugs.Methods and analysisThis population-based cohort study will use longitudinal data on almost 40 000 people aged 65 years or older who were hospitalised in Western Australia between 2003 and 2008 for coronary heart disease, heart failure or atrial fibrillation. Linking of several State and Federal government administrative data sets will provide person-based information on drugs dispensed precardiac and postcardiac event, reasons for hospital admission, emergency department visits, mortality and medical visits. Dispensed drug trends will be described, drug adherence measured and their association with future all-cause/cardiovascular events will be estimated. The cost-effectiveness of these long-term therapies for cardiac disease and the impact of adherence will be evaluated.Ethics and disseminationHuman Research Ethics Committee (HREC) approvals have been obtained from the Department of Health (Western Australian #2011/62 and Federal) and the University of Western Australia (RA/4/1/1130), in addition to HREC approvals from all participating hospitals. Findings will be published in peer-reviewed medical journals and presented at local, national and international conferences. Results will also be disseminated to consumer groups.

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Problems with medicine use in older Australians: a review of recent literature

Elliott

Booth

2014

J Pharm Pract Res

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Abstract:Older people are at increased risk of medication-related problems and adverse medication events. This paper reviews literature on problems with medicine use in older Australians published between 2006 and 2013. The prevalence of polypharmacy has continued to rise. Polypharmacy, multiple comorbidities and inappropriate prescribing have been linked to drug-drug and drug-disease interactions and medicine-related hospitalisations. Inaccurate medication histories, suboptimal continuity of medication management, complex medication regimens and non-adherence have been reported. Studies describing medication reviews, usually conducted by pharmacists, indicate that older people taking multiple medicines have an average of one to three current medication-related problems, including inappropriate or unnecessary medicines, untreated indications, suboptimal monitoring and adverse drug reactions. These findings indicate that problems with medicine use and adverse medication events remain highly prevalent in older Australians, despite the introduction of a range of quality use of medicines strategies. This may be due to a range of factors such as increasing intensity and complexity of medical therapy, and suboptimal uptake and /or targeting of quality use of medicines strategies. In settings where quality use of medicines strategies have been implemented, there is evidence for improved prescribing and, in some situations, reduced adverse events. Problems with medicine use in older people remain a major challenge to the Australian healthcare system: polypharmacy may be unavoidable in people with multiple comorbidities, so there needs to be a focus on managing and reducing the risks associated with polypharmacy.

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Assessing overall duration of cardiovascular medicines in veterans with established cardiovascular disease

Cited by 15 publications

References 18 publications

Secondary preventive medication use in a prevalent population‐based cohort of acute coronary syndrome survivors

Secondary preventive medication use in a prevalent population‐based cohort of acute coronary syndrome survivors

Long-term use and cost-effectiveness of secondary prevention drugs for heart disease in Western Australian seniors (WAMACH): a study protocol

Problems with medicine use in older Australians: a review of recent literature

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