Long-term medication adherence after myocardial infarction: experience of a community.
Long-term medication adherence after myocardial infarction: experience of a community.
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DOI：
10.1016/j.amjmed.2008.12.021
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发表时间：
2009-10
影响因子：
5.9
通讯作者：
Roger, Veronique L.
中科院分区：
文献类型：
--
作者：
Shah, Nilay D.;Dunlay, Shannon M.;Ting, Henry H.;Montori, Victor M.;Thomas, Randal J.;Wagie, Amy E.;Roger, Veronique L.
心肌梗死后坚持循证药物治疗与预后改善相关然而，长期数据的因素影响心肌梗死后的药物治疗依从性是缺乏的。确定了1997-2006年因心肌梗死住院的奥姆斯特德县居民。检查HMG-CoA还原酶抑制剂（他汀类药物）、β受体阻滞剂、血管紧张素转换酶抑制剂（ACE抑制剂）和血管紧张素II受体阻滞剂（ARB）的依从性。考克斯比例风险回归用于确定随时间推移与药物依从性相关的因素。在292例发生心肌梗死的患者中（63%为男性，平均年龄65岁），患者平均随访52±31个月。对指南推荐药物的依从性随着时间的推移而下降，他汀类药物、β受体阻滞剂和ACE抑制剂/ARB的3年药物继续使用率分别为44%、48%和43%。参加心脏康复计划与继续用药的可能性增加相关，心脏康复参与者中停用他汀类药物和β受体阻滞剂的校正风险比（95%置信区间）分别为0.66（0.45-0.92）和0.70（0.49-0.98）。心肌梗死时吸烟与继续用药的可能性降低相关，尽管结果未达到统计学显著性。在人口统计学特征、心肌梗死临床特征和药物依从性之间未观察到相关性。心肌梗死后，随着时间的推移，大部分患者停止使用药物。心肌梗死后参加心脏康复治疗与药物依从性改善相关。
Adherence to evidence-based medications after myocardial infarction is associated with improved outcomes. However, long-term data on factors affecting medication adherence after myocardial infarction are lacking. Olmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified. Adherence to HMG-CoA reductase inhibitors (statins), beta blockers, angiotensin-converting enzyme inhibitors (ACE Inhibitors), and angiotensin II receptor blockers (ARB), were examined. Cox proportional hazard regression was used to determine the factors associated with medication adherence over time. Among 292 persons with incident myocardial infarction (63% men, mean age 65 years), patients were followed for an average of 52±31 months. Adherence to guideline-recommended medications declined over time, with 3-year medication continuation rates of 44%, 48%, and 43% for statins, beta blockers, and ACE Inhibitors/ARB, respectively. Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications, with adjusted hazard ratio (95% confidence interval) for discontinuation of statins and beta blockers among cardiac rehabilitation participants of 0.66 (0.45-0.92) and 0.70 (0.49-0.98), respectively. Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications, though results did not reach statistical significance. There were no observed associations between demographic characteristics, clinical characteristics of the myocardial infarction and medication adherence. After myocardial infarction, a large proportion of patients discontinue use of medications over time. Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherence.
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影响因子：
120.7
作者：
OLDRIDGE, NB;GUYATT, GH;RIMM, AA
通讯作者：
RIMM, AA
影响因子：
--
作者：
Ho, P. Michael;Spertus, John A.;Rumsfeld, John S.
通讯作者：
Rumsfeld, John S.
影响因子：
120.7
作者：
Jackevicius, CA;Mamdami, M;Tu, JV
通讯作者：
Tu, JV
影响因子：
37.8
作者：
Jackevicius, Cynthia A.;Li, Ping;Tu, Jack V.
通讯作者：
Tu, Jack V.
影响因子：
--
作者：
Daugherty, Stacie L.;Ho, P. Michael;Masoudi, Frederick A.
通讯作者：
Masoudi, Frederick A.