Optimal pharmacological treatment and adherence to medication in secondary prevention of cardiovascular events in Spain: Results from the CAPS study

• Published in: Cardiovascular therapeutics 2017-04, Vol.35 (2), p.n/a
• Main Authors: Cordero, Alberto, Rodriguez Padial, Luis, Batalla, Alberto, López Barreiro, Luis, Torres Calvo, Francisco, Castellano, Jose M., Ruiz, Emilio, Bertomeu‐Martínez, Vicente
• Format: Article
• Language: English
• Subjects: Adherence; Aged; Cardiovascular; Cardiovascular Agents - adverse effects; Cardiovascular Agents - therapeutic use; Cardiovascular Diseases - diagnosis; Cardiovascular Diseases - epidemiology; Cardiovascular Diseases - prevention & control; Cross-Sectional Studies; Drug Prescriptions; Drug Therapy, Combination; Female; Guideline Adherence; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - adverse effects; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Male; Medication Adherence; Middle Aged; Optimal treatment; Polypharmacy; Practice Guidelines as Topic; Practice Patterns, Physicians; Recurrence; Risk Factors; Secondary prevention; Secondary Prevention - methods; Secondary Prevention - standards; Secondary Prevention - trends; Socioeconomic Factors; Spain - epidemiology; Surveys and Questionnaires; Time Factors; Treatment Outcome
• ISSN: 1755-5914; 1755-5922
• DOI: 10.1111/1755-5922.12240

Summary Introduction Despite the large amount of evidence supporting the use of antiplatelet agents, beta‐blockers, angiotensin antagonists, and lipid‐lowering statins in patients with stable coronary artery disease, several studies have documented underprescription of optimal medical treatment (OMT) in Spain. Aims The present study aimed to describe the current trend of pharmacological prescription in secondary prevention treatment for cardiovascular diseases (CVDs) in a Spanish cohort. Methods This study was a multicenter, observational, cross‐sectional study (CAPS study, FER‐CAR‐2014‐01) in the context of only one visit. Adherence levels to the prescribed medication, the reasons for not prescription of each medication, the existence of possible associations between sociodemographic features, different CVDs, and different drugs with treatment compliance were also analyzed in patients who have suffered cardiovascular effects. Results Six hundred and twelve patients (68.5±10.7 years old; 78% males) were included. OMT was prescribed in 40.8% of the patients. The main reason for not prescribing was due to the physician's discretion. Adherence to medication, measured by the Morisky‐Green questionnaire, was 45.8%, and it was positively related to the presence of coronary events (OR 1.80; 95% CI: 1.05‐3.21) but not with any drug type. Moreover, a higher educational background implied a higher percentage of adherence to medication. Finally, nonadherent patients were prescribed more daily medicine intakes. Conclusions Low adherence to guideline‐oriented treatment as well as low adherence to medication was found by a self‐reported questionnaire. Enhancing adherence to guideline‐recommended therapy and reducing treatment complexity seem to be reasonable strategies to improve adherence to secondary prevention medications.