While the age-old problem of people not taking their statins after suffering a heart attack still occurs far too often, it’s a situation that slowly has been improving.
But in a paper published in JAMA Cardiology, the authors concluded a significant number of patients weren’t taking their medication as directed two years after discharge.
Dr. Robert S. Rosenson and colleagues at the Icahn School of Medicine at Mount Sinai Hospital, New York reviewed the cases of 29,932 Medicare beneficiaries ages 66 to 75 and the records of 27,956 Medicare patients older than 75.
They found that at six months and two years after discharge, only 59 percent and 42 percent of patients, respectively, were still taking their medications as directed. Blacks, Hispanics and people not previously given statins after a heart attack had the lowest medication adherence rates.
The study was conducted between 2007 and 2012. About half the patients were women; four-fifths were white.
Statins are known for causing some unpleasant side effects. High-intensity statins, which were used for this study, have even harsher side effects than low-intensity statins.
“In a prior study, statin adherence was higher among patients with vs. without a physician visit within six weeks following a (heart attack) hospitalization,” the authors wrote. “Follow-up visits after a (heart attack) allow physicians to assess medication adherence and identify factors associated with low statin adherence including adverse effects, perceived lack of efficacy, and cost issues.”
The report said African Americans, Hispanics, and those taking high-intensity statins for the first time need special monitoring due to the low adherence observed in this study.
Some people may not be taking their medications because they cannot afford them, the authors noted. “The association between reaching the Medicare medication coverage gap and high-intensity statin use with high adherence may be owing to high medication adherence being associated with greater costs.”
The authors call for more research into this matter, adding, “Lower medication costs, cardiologist visits, and cardiac rehabilitation may contribute to improving high-intensity statin use and adherence after (heart attack).”