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Drug Adherence with Cardiovascular Medicines: Statins and Aspirin

  • Maarit Jaana Korhonen
  • Emma Aarnio
Chapter
Part of the Updates in Hypertension and Cardiovascular Protection book series (UHCP)

Abstract

Statins and aspirin are both widely used low-cost therapies, with known adverse effect profiles, that are prescribed to treat a symptomless condition or to prevent future adverse cardiovascular events. Despite their proven efficacy in the prevention of cardiovascular morbidity and mortality, non-adherence to these medicines is prevalent. Reported rates of non-adherence vary substantially across studies; based on meta-analyses, only every second patient who initiates statin therapy adheres to it, and non-adherence is more common in primary than in secondary prevention. Adherence to aspirin is somewhat better, being comparable to statin adherence in secondary prevention (~70%). However, these rates underestimate non-adherence by missing those who do not initiate medicine use (primary non-adherence). Use of these cardioprotective medicines is a dynamic process where adherence can change over time and many patients who discontinue medicine use reinitiate it. The most important patient-reported reason for non-adherence is adverse effects. Recently, negative media coverage has been implicated as a reason for discontinuation of statin therapy. The multitude of risk factors for non-adherence, in addition to complexity of adherence behavior, is likely to complicate efforts to improve adherence to statins and aspirin.

Keywords

Adherence Aspirin Cardiovascular disease Dyslipidemia Persistence Statins 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Institute of BiomedicineUniversity of TurkuTurkuFinland
  2. 2.Faculty of Pharmacy and Pharmaceutical SciencesCentre for Medicine Use and Safety, Monash UniversityMelbourneAustralia

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