I'd be interested in people's comments on this report? ----------------------------------------------------------------------
Heart meds: half patients don't comply http://www.pharmainfocus.com.au/news.asp?newsid=1732 Posted 28 May 2007 A vast problem with cardiovascular medicines compliance in Australia has been confirmed by the latest research from the Australian Institute of Health and Welfare (AIHW). A report released last week, "Medicines for cardiovascular health: are they used appropriately?" examines how medicines for cholesterol reduction, hypertension and ischaemic heart disease are being prescribed by GPs and used by patients. Susana Senes of the Institute's Cardiovascular Disease and Diabetes Unit, said 10% to 25% of patients had discontinued their medicines six months after starting treatment, and this rose to 21% to 47% 24 months after first being prescribed medication. "Overall, the results of our study indicate a high level of discontinuation of medicines that are generally intended to be taken long-term. This represents a significant waste of resources and a lost opportunity to prevent cardiovascular disease with medicines known to be effective," the study report said. The statistical study was based on BEACH data from 2000 to 2006 and found that persistence - continuing to take prescribed medications - and compliance - taking them at the correct frequency and dose - both declined after patients were initially prescribed. In particular it revealed that one in six patients (17%) had discontinued statins at six months from the start of therapy. This figure exceeded one in three after 24 months (35%). "In the first 12 months of therapy, 77% of newly prescribed patients were assessed as compliant with statins, that is, they had sufficient medicine to use it at the prescribed frequency and dose," the report said. The picture was somewhat better for angiotensin II receptor antagonists and ACE inhibitors with 88–91% of patients persisting with treatment after six months. After 24 months 75–79% were still taking the medicines. The higher figures were for combination products. Eighty-seven percent of newly prescribed patients were assessed as compliant with ACE inhibitors or plain angiotensin II antagonists, and 89% were compliant with angiotensin II antagonists combinations. Three quarters of beta-blocker patients continued filling their prescriptions at six months but by 24 months this had dropped to almost half. The same survey found that over 365,000 patients only ever received one script for a cardiovascular medication resulting, it said, in a minimum cost to government and patients of $7.4 million which was effectively wasted. Although the AIHW said it did not have access to patient information that would allow it to explore why patients were stopping their medications, "The fact that for the most part our analyses were confined to concessional patients, for whom out-of-pocket expenses on medicines would be relatively low, suggests that cost does not play a big role". It quoted other research showing that factors associated with poor concordance (persistence and compliance) include the treatment of a condition with no symptoms (such as high blood pressure and high blood cholesterol), the presence of depression, inadequate follow-up or discharge planning, side effects, poor communication between health professional and patient, patient’s lack of understanding of their condition, patient’s lack of belief in the benefit of treatment, complexity of treatment, missing doctor’s appointments and cost. _______________________________________________ Gpcg_talk mailing list [email protected] http://ozdocit.org/cgi-bin/mailman/listinfo/gpcg_talk
