Interventions promoting adherence to cardiovascular medicines

Abstract

Several types of interventions are effective in improving adherence and/or persistence within the CVD area and in the community setting. Behavioural interventions have shown the greatest success (compared to other types of interventions); and adding informational strategies has not resulted in further improvements in adherence. Improving adherence and persistence to cardiovascular medicines is a dynamic process that is influenced by many factors, and one which requires long term multiple interventions to promote medicine taking in patients.

Impact of Statin Adherence on Cardiovascular Morbidity and All-Cause Mortality in the Primary Prevention of Cardiovascular Disease: A Population-Based Cohort Study in Finland

“…Our findings support the need for physicians, pharmacists, and other health care professionals to highlight the importance of adherence to all patients taking statins. Even though there appears to be a need to implement systematic interventions that support adherence [45], it is important to assess the effectiveness, costeffectiveness, and budget impact of such interventions, especially in primary prevention populations. This need is highlighted by the large number of individuals using statins in the primary prevention of CV diseases and the possibility to enhance the expected benefits and cost-effectiveness of these interventions by targeting the programs to high-risk patients in primary prevention.…”

Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications

“…Moreover, methodological impediments have emerged; for instance, self-reported questionnaires -the cheapest and the easiest way to measure the adherence level, have over-or under-estimated this phenomenon [9,10]. It should be noted that medical records, patient databases and pharmacy refill statistics, all which clearly aid in evaluating adherence in a large patient cohort; oversimplify the multidimensional character of adherence [11]. The use of a pill count tracker or electronic bottles may unknowingly change the patients' behavior in regards to medication adherence, and thus, the estimation of adherence provided might prove unreliable.…”

Recursos psicosociales positivos y salud cardiovascular

“…Varios mecanismos explicarían estos hallazgos: la afectividad positiva podría facilitar la conexión que establece el paciente entre su esfuerzo, el cambio de conducta y el sentido de autoeficacia, atenuar los efectos negativos de la depresión sobre la adherencia a la medicación y estimular la adopción de comportamientos de salud más positivos. Estos resultados son consistentes con evidencia previa que indica que las intervenciones psicoconductuales tienen mayor éxito -en comparación con intervenciones exclusivamente informativas y educacionales-sobre la adherencia al uso de fármacos cardiovasculares 59 . Sin embargo, se requieren estudios más prolongados para establecer si los cambios favorables observados en el estilo de vida y en la adherencia a tratamiento en los grupos intervenidos se traducen realmente en una mejoría de resultados clínicos a largo plazo.…”