Cardiac Patients With Longer Prescriptions at Discharge More Likely to Adhere to Drug Regime

A latest study reveals a strong association between longer prescriptions at discharge and long term adherence to it in elderly cardiac patients.

According to the study published in the Canadian Journal of Cardiology, elderly cardiac patients prescribed heart medications for 60 days or longer at discharge are four times more likely to adhere to the drug regime than patients who are given the same medications for 30 days.

The study conducted at the Institute for Clinical Evaluative Sciences (ICES) and Women's College Hospital (WCH), suggests that the prescriptions given for a longer interval of time are not just effective but also patient centered.

"Studies show that adherence to cardiac medications after a cardiac event like a heart attack declines over time. But we know that taking these medications for the long-term is absolutely essential for preventing further cardiac events," said Dr. Noah Ivers, lead author of the study and family physician at Women's College Hospital. "This study shows that longer prescriptions for cardiac patients after leaving hospital increase the likelihood that patients will take the medications for the long term, which may reduce their risk of heart attacks, stroke or even death."

The researchers examined medication adherence with ACE inhibitors, beta blockers and statins in 20,000 elderly patients who had coronary heart diseases. After 18 months the researchers compared the results of those prescribed with medication for 60 days or more, for 30-60 days and for less than 30 days.

They noticed that those who were prescribed medication for 60 days or more were more likely to adhere to the medication in the long term when compared to those who took medication for 30 days or less. When compared to the young patients, older patients were more likely to continue with medications and male patients were more likely to continue to take some medication. Nearly 50 percent of the prescriptions lasted for just 7 days and regardless of the length of the prescriptions nearly 80 percent of the patients had a follow up appointment.

Dr. Ivers said that most of the patients in the study were discharged from the hospital with cardiac medication that was prescribed for 30 days or less. This may be the consequence of common clinical perception that short prescriptions encourage patients to go for follow-up appointments. But in this study, irrespective of the duration of prescriptions, all the patients attended the follow up appointment.

Short prescriptions may unintentionally suggest to patients as well as the family physicians that long term adherence is not necessary.