Impact of Polypharmacy on Adherence to Evidence-Based Medication in Patients who Underwent Percutaneous Coronary Intervention

Author(s): Shaban Mohammed, Abdulrahaman Arabi, Ayman El-Menyar, Sabir Abdulkarim, Amer AlJundi, Awad Alqahtani, Salah Arafa, Jassim Al Suwaidi.

Journal Name: Current Vascular Pharmacology

Volume 14 , Issue 4 , 2016

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Abstract:

Background: The primary objective of this study was to evaluate the impact of polypharmacy on primary and secondary adherence to evidence-based medication (EBM) and to measure factors associated with non-adherence among patients who underwent percutaneous coronary intervention (PCI).

Methods: We conducted a retrospective analysis for patients who underwent PCI at a tertiary cardiac care hospital in Qatar. Patients who had polypharmacy (defined as ≥6 medications) were compared with those who had no polypharmacy at hospital discharge in terms of primary and secondary adherence to dual antiplatelet therapy (DAPT), beta-blockers (BB), angiotensin converting enzyme inhibitors (ACEIs) and statins.

Results: A total of 557 patients (mean age: 53±10 years; 85%; males) who underwent PCI were included. The majority of patients (84.6%) received ≥6 medications (polypharmacy group) while only 15.4% patients received ≥5 medications (nonpolypharmacy group). The two groups were comparable in term of gender, nationality, socioeconomic status and medical insurance. The non-polypharmacy patients had significantly higher adherence to first refill of DAPT compared with patients in the polypharmacy group (100 vs. 76.9%; p=0.001). Similarly, the non-polypharmacy patients were significantly more adherent to secondary preventive medications (BB, ACEI and statins) than the polypharmacy group.

Conclusion: In patients who underwent PCI, polypharmacy at discharge could play a negative role in the adherence to the first refill of EBM. Further studies should investigate other parameters that contribute to long term non-adherence.

Keywords: Polypharmacy, adherence, percutaneous coronary intervention, evidence-based medication.

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Article Details

VOLUME: 14
ISSUE: 4
Year: 2016
Page: [388 - 393]
Pages: 6
DOI: 10.2174/1570161113666151030105805
Price: $58

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