Long-term medication adherence after myocardial infarction (MI) in the elderly is low, especially in patients with kidney dysfunction, according to a study published online in the Clinical Journal of the American Society of Nephrology.
Researchers led by Wolfgang C. Winkelmayer, MD, ScD, of Stanford University School of Medicine in Palo Alto, Calif., used data from patients who were older than 65 years and hospitalized for MI in Pennsylvania in 1999 and 2000. Researchers examined that association of baseline kidney function with long-term adherence to recommended medications after MI, including ACE inhibitors and angiotensin II receptor blockers (ARBs), beta-blockers, and statins. Researchers determined filled prescriptions for these drugs using claims from the Pharmaceutical Assistance Contract for the Elderly.
The investigators reported that elderly survivors of MI showed overall low rates of long-term adherence to the three medication classes studied. By 12 months, 35%-40% of the study population was nonadherent to treatment with ACE inhibitors/ARBs, beta-blockers, and statins, and this percentage increased to 40%-48% and 45%-55% by 24 and 36 months, respectively.
“The results of our analysis have important clinical implications because elderly patients with kidney dysfunction are at high risk for cardiovascular mortality and may therefore benefit the most from dedicated interventions aimed at improving long-term medication adherence,” the authors wrote.
They also noted: “Future strategies should pay special attention to the elderly with kidney dysfunction because this population may be especially vulnerable to poor long-term medication adherence and its adverse consequences.”