Medication adherence by elderly after MI is low

Elderly patients have difficulty with long-term adherence to medications following myocardial infarction (MI), and this is significantly worse among those with kidney dysfunction, according to a study published online January 13 in the Clinical Journal of the American Society of Nephrology, HealthDay News reported.

Tara I. Chang, MD, of the Stanford University School of Medicine (California) and colleagues examined long-term adherence to medications in a cohort of 2,103 patients aged older than 65 years who were discharged from the hospital after an MI. Patients were treated with one of the recommended medication classes: angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs), beta-blockers, and statins. Adherence to these medications was measured by the percentage of days covered for 36 months according to pharmacy refill data.

Long-term adherence to each medication class was poor, investigators found. On average, patients took their medications for only 50% to 60% for all 3 medication classes during the 36-month study period. Additionally, patients who had baseline kidney dysfunction had significantly lower long-term adherence to ACEI/ARB and beta-blockers. Long-term adherence to statins did not vary according to the level of kidney function.

“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,” the authors wrote.