Poor Compliance With Carrying Nitroglycerin and Aspirin in Patients With Coronary Artery Disease

Horsman, Catherine; Frederick, Tammy

doi:10.1016/j.cjca.2018.03.005

Cited by 1 publication

(2 citation statements)

References 3 publications

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“…The first group is the population with established CAD, whose compliance with carrying ASA and standard nitroglycerin spray formulations is poor. 11 The second group comprises people with risk factors for myocardial infarction but without a previous cardiac ischemic event. Canadians have a high prevalence of risk factors for CAD, 18 and treatment of modifiable risk factors reduces, but does not eliminate, the risk of myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

“…In a prospective Canadian case series conducted in a primary care clinic, 38 consecutive patients with CAD were asked to produce their prescribed nitroglycerin and recommended ASA to a nurse. 11 Only 7 (18%) of the 38 carried their nitroglycerin; among men, the rate was 12% (2/17). The most frequent explanation for lack of compliance was the inconvenience of carrying nitroglycerin spray.…”

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confidence: 98%

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Development and validation of a compact on-person storage device (SMHeartCard) for emergency access to acetylsalicylic acid and nitroglycerin

Paterson

Davies

et al. 2020

cmajo

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Background: Guidelines recommend that patients with coronary artery disease (CAD) carry and immediately use acetylsalicylic acid (ASA) and sublingually administered nitroglycerin at the onset of chest pain; however, compliance with these recommendations is poor. We designed and tested a compact on-person storage device for these medications. Methods:We designed an airtight, light-proof and chemically inert holder to carry four 81-mg ASA tablets and three 0.3-mg Nitrostat (nitroglycerin, Pfizer) tablets. After establishing the temperatures ranges in wallets and pockets, we tested nitroglycerin dissolution and release of the stored Nitrostat tablets across a range of relevant temperatures and a variety of tablet enclosure systems. Results:Microcalorimeter thermal conduction studies as well as dissolution and release testing showed that nitroglycerin tablets were stable at temperatures ranging from -20°C to 60°C for 1 week. In testing up to 24 weeks, 0.3-mg Nitrostat tablets enclosed completely in polytetrafluoroethylene (PTFE) performed similarly to those stored in the manufacturer's borosilicate glass packaging across a wide range of temperatures relevant to on-person carriage. Real-world on-person testing for 24 weeks confirmed these results. Non-PTFE enclosures performed poorly. Interpretation:The PTFE enclosure with a PTFE-coated cap liner maintained long-term performance of 0.3-mg Nitrostat tablets under laboratory and real-world conditions. This storage device is now commercially available as the SMHeartCard to improve compliance and provide immediate access to emergency cardiac medications. AbstractResearch E76 CMAJ OPEN, 8(1)

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Section: Discussionmentioning

confidence: 99%

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confidence: 98%