Medication Adherence in Cardiovascular Disease
2010; Lippincott Williams & Wilkins; Volume: 121; Issue: 12 Linguagem: Inglês
10.1161/circulationaha.109.904003
ISSN1524-4539
AutoresSteven Baroletti, Heather Dell’Orfano,
Tópico(s)Pharmaceutical Economics and Policy
ResumoHomeCirculationVol. 121, No. 12Medication Adherence in Cardiovascular Disease Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBMedication Adherence in Cardiovascular Disease Steven Baroletti, PharmD, MBA and Heather Dell'Orfano, PharmD Steven BarolettiSteven Baroletti From the Department of Pharmacy, MetroWest Medical Center, Framingham (S.B.), and Brigham and Women's Hospital, Boston (H.D.), Mass. and Heather Dell'OrfanoHeather Dell'Orfano From the Department of Pharmacy, MetroWest Medical Center, Framingham (S.B.), and Brigham and Women's Hospital, Boston (H.D.), Mass. Originally published30 Mar 2010https://doi.org/10.1161/CIRCULATIONAHA.109.904003Circulation. 2010;121:1455–1458A 66-year-old woman presents to the emergency department with crushing chest pain and ST-segment elevations on ECG. She has left ventricular systolic dysfunction (ejection fraction, 35%) after recent (6 days earlier) non–ST-segment elevation myocardial infarction treated with percutaneous coronary intervention, including 2 drug-eluting stents. She is sent for emergent cardiac catheterization, is found to have in-stent thrombosis, and subsequently is revascularized. After being transferred to the coronary care unit, she undergoes further workup. Before her previous admission, her home medication regimen included aspirin, lisinopril, atenolol, atorvastatin, spironolactone, furosemide, potassium, and sublingual nitroglycerin. At the time of her latest discharge, her medication regimen consisted of an increased dose of aspirin, the addition of clopidogrel, and a change in atenolol dose, in addition to all other previous medications. During the history and physical examination, it is discovered that she had not filled any of her new prescriptions after discharge from the hospital 5 days ago. She explains, "I already had all my drugs in my medicine cabinet at home."NonadherenceNonadherence to medications has been documented to occur in >60% of cardiovascular patients.1 Self-reported adherence to cardiovascular medications in patients who have coronary artery disease is <40% for the combination of aspirin, β-blocker, and a lipid-lowering agent in both isolated and long-term follow-up surveys2 (Table 1). Table 1. Adherence Rates to Common Cardiovascular MedicationsMedicationSelf-Reported Adherence, %Consistent Adherence, %**More than 2 consecutive follow-up surveys over 6±12 months.Aspirin8371Lipid-lowering agents6346β-blockers6144Aspirin+β-blocker5436Aspirin+β-blocker+lipid-lowering agent3921The immediate discharge period is a time of high risk for nonadherence. Nearly 1 in 4 patients is partially or completely nonadherent in filling prescriptions after discharge.3 Of the patients who are initially adherent, up to 50% will discontinue antihypertensive medications within 6 to 12 months, and only ≈40% continue statin medications for 2 years after hospitalization for acute coronary syndrome.2,4Primary nonadherence (not initially filling the prescription written) leads to a significant increase in 1-year mortality after hospitalization for myocardial infarction.3 Secondary nonadherence (failure to follow the instructions or to refill the prescription) has been shown to increase mortality, hospitalizations, and costs.5–8Patients with high adherence rates have a significantly lower risk of cardiovascular events compared with those with low adherence rates.9 Those who filled none of their discharge prescriptions within 120 days after myocardial infarction had an 80% increased odds of death and those who filled only some of their prescriptions had a 44% increased odds of death compared with those who filled most of their prescriptions.3CausesWe care for our patients in a fast-paced, high-level environment. Their medication regimens have become increasingly complex. Factors of nonadherence can be categorized into 3 major groups: socioeconomic, communication-related, and motivational (Figure 1). Download figureDownload PowerPointFigure 1. Causes of medication nonadherence.Socioeconomic factors are derived from the patients' inability to afford or difficulty in affording their medication. They may include lack of adequate healthcare coverage, unemployment, retirement, and indigence. Some studies have shown that socioeconomic factors and low health literacy in patients with cardiovascular disease contribute to nonadherence.Effective communication requires providing medication instructions at a level that the patient can understand. Health illiteracy is a major ongoing problem.10 Inadequate communication is often multifactorial. Aggravating circumstances include languages other than English as the primary household language, cultural barriers, low functional literacy, substance or alcohol abuse, and mental illness. Those with depression or other significant psychiatric illnesses, heavy drinkers, and nonwhite patients have been associated with risk for low adherence rates.2,11Lack of motivation has been identified as a barrier to medication adherence in patients who are able to effectively communicate and can comfortably afford their medications. These patients' nonadherence is not due to a choice between affording food or their medication but rather to their lack of understanding the gravity of their illness or the benefit that the medication will provide. This issue is often compounded by a fear of potential side effects or toxicities associated with their medications. Cultural beliefs may also play a role in medication nonadherence.National patient surveys have shown that patients are less likely to take a medication if it does not correlate with a noticeable beneficial effect. Unlike analgesics, antiemetics, or antibiotics, many medications in the armamentarium against cardiovascular disease have a preventive mechanism that does not demonstrate noticeable symptom relief to the patient. The use of antiplatelet agents to prevent in-stent thrombosis, high-dose statin therapy after acute coronary syndromes, or antihypertensive agents in asymptomatic patients may all be perceived by a patient as not providing benefit because they simply do not feel better.Finally, a lack of perceived need or concern about adverse effects may also decrease adherence rates. Conflicting information exists on the roles that age and regimen complexity play as risk factors.3,12SolutionsThe reasons for nonadherence are often multifactorial; therefore, multimodal interventions are generally more successful than a unimodal approach.13 Solutions to overcoming patient-specific barriers to nonadherence do not have to consume valuable time or resources.In the HospitalIf therapy is initiated in the hospital, the patient is most likely to relate the drug to the disease; intensive education by the medical team at this opportune time may improve adherence. Patients will have a perceived importance of medications used in the hospital setting and often have more dialogue with physicians, pharmacists, and nurses about medications, including discussions about possible adverse effects.14 Management strategies should be tailored to patient needs, and patients should be educated about the goals of treatment and potential adverse effects, thus becoming part of the decision-making process.14,15Methods shown to improve medication adherence are discharge medication counseling, positive interactions between clinician and patient, close follow-up with patients (1 to 2 weeks after discharge), low costs or copayments for prescription medications, and simplified drug regimens.3,16 It is helpful to initiate motivational strategies, including daily drug reminder charts, training on self-determination, reminders, social support, nurse telephone calls, family member support, and telephone-linked computer counseling.16,17In the OfficeThe first and most crucial step in ensuring medication adherence is to determine whether the patient can communicate and process the information that you are sharing. If you are not able to effectively communicate with the patient, monitoring prescription refills, counting pills, and involving friends or family members are of value when nonadherence is suspected.18,19 Once specific factors are identified, an appropriate tool should be used to facilitate understanding (Figure 2). Download figureDownload PowerPointFigure 2. Strategies to identify and address major causes of medication nonadherence.Once effective communication is achieved, simple attempts to determine the patients' ability to pay for the medication should be made through a series of questions that ask patients what pharmacy they use, who their insurance carrier is, or what their current profession is. A patient will often give clues that they may not be able to afford their medication. Fortunately, programs continue to emerge that are designed to help patients acquire medication at a fraction of the cost (Table 2). Table 2. Resources to Address Medication NonadherenceDescriptionResource/ToolsSocioeconomic Access to no- or low-cost medication and links to patient assistance and disease-based programshttp://www.needymeds.com Access to patient payment assistance programs and discounted prescription medicationshttp://www.rxassist.comCommunication Web sitehttp://clearhealthcommunication.com/public-health-professionals/tips-for-providers.html Link to patient counseling tools in multiple languageshttp://www.rxtran.com/Motivation Patient-directed publications for the management of various disease stateshttp://circ.ahajournals.org/collected/patient.shtml Guide to understanding motivation styleshttp://www.learnativity.com/motivation.htmlMotivation is the most elusive reason for medication nonadherence. Patients will often respond to instructions with a learned series of nods and "yes" responses. Asking patient to explain the reason they are prescribed each medication may reveal their lack of understanding, which predicts a high likelihood of poor adherence.ConclusionsNonadherence to medications remains a major problem for cardiovascular patients. It leads to poor clinical outcomes, including rehospitalization, subsequent myocardial infarction, and increased mortality in various patient settings. Clinicians need to use multiple approaches to simple solutions to improve their patients' short- and long-term medication adherence.Case PresentationThe physician caring for the patient recognized the problem with primary nonadherence and instituted a multimodal approach to increase adherence. Family member support was obtained, and discharge medication counseling and a daily drug reminder chart were provided. In addition, a follow-up appointment 2 weeks after discharge was scheduled with her cardiologist. At her 2-week appointment, she was able to explain the reasons for each medication and describe how she was taking them. She acknowledged that she was able to pay for her medications, and she was motivated by her cardiologist to continue adhering to her medication regimen.DisclosuresNone.FootnotesCorrespondence to Steven Baroletti, Department of Pharmacy, MetroWest Medical Center, 115 Lincoln St, Framingham, MA 01702. E-mail [email protected] References 1 Kravitz RL, Hays RD, Sherbourne CD, DiMatteo MR, Rogers WH, Ordway L, Greenfield S. Recall of recommendations and adherence to advice among patients with chronic medical conditions. Arch Intern Med. 1993; 153: 1869–1878.CrossrefMedlineGoogle Scholar2 Newby LK, LaPointe NM, Chen AY, Kramer JM, Hammill BG, DeLong ER, Muhlbaier LH, Califf RM. Long-term adherence to evidence-based secondary prevention therapies in coronary artery disease. Circulation. 2006; 113: 203–212.LinkGoogle Scholar3 Jackevicius CA, Li P, Tu JV. Prevalence, predictors, and outcomes of primary nonadherence after acute myocardial infarction. Circulation. 2008; 117: 1028–1036.LinkGoogle Scholar4 Jackevicius CA, Mamdani M, Tu JV. Adherence with statin therapy in elderly patients with and without acute coronary syndromes. JAMA. 2002; 288: 462–467.CrossrefMedlineGoogle Scholar5 Sokol MC, Mcguigan KA, Verbrugge RR, Epstein RS. Impact of medication adherence on hospitalize statin risk and healthcare cost. Med Care. 2005; 43: 521–530.CrossrefMedlineGoogle Scholar6 Simpson SH, Eurich DT, Majumdar SR, Padwal RS, Tsuyuki RT, Varney J, Johnson JA. A metaanalysis of the association between adherence to drug therapy and mortality. BMJ. 1006; 333: 18–26.CrossrefMedlineGoogle Scholar7 Rasmussen JN, Chong A, Alter DA. Relationship between adherence to evidence-based pharmacotherapy and long-term mortality after acute myocardial infarction. JAMA. 2007; 297: 177–186.CrossrefMedlineGoogle Scholar8 Ho PM, Magid DJ, Shetterly SM, Olson KL, Maddox TM, Peterson PN, Masoudi FA, Rumsfeld JS. Medication nonadherence is associated with a broad range of adverse outcomes in patients with coronary artery disease. Am Heart J. 2008; 155: 772–779.CrossrefMedlineGoogle Scholar9 Mazzaglia G, Ambrosioni E, Alacqua M, Filippi A, Sessa E, Immordino V, Borghi C, Brignoli O, Caputi AP, Cricelli C, Mantovani LG. Adherence to antihypertensive medications and cardiovascular morbidity among newly diagnosed hypertensive patients. Circulation. 2009; 120: 1598–1605.LinkGoogle Scholar10 Oates DJ, Paasche-Orlow MK. Health literacy: communication strategies to improve patient comprehension of cardiovascular health. Circulation. 2009; 119: 1049–1051.LinkGoogle Scholar11 Bourgault C, Senecal M, Brisson M, Marentette MA, Gregoire JP. Persistence and discontinuation patterns of antihypertensive therapy among newly treated patients: a population-based study. J Hum Hypertens. 2005; 19: 607–613.CrossrefMedlineGoogle Scholar12 Vik SA, Maxwell CJ, Hogan DB. Measurement, correlates, and health outcomes of medication adherence among seniors. Ann Pharmacother. 2004; 38: 303–312.CrossrefMedlineGoogle Scholar13 Ho PM, Bryason CL, Rumsfeld JS. Medication adherence: its importance in cardiovascular outcomes. Circulation. 2009; 119: 3028–3035.LinkGoogle Scholar14 Petrilla AA, Benner JS, Battleman DS, Tierce JC, Hazard EH. Evidence-based interventions to improve compliance with antihypertensive and lipid-lowering medications. Int J Clin Pract. 2005; 59: 1441–1451.CrossrefMedlineGoogle Scholar15 Fanikos J, Stevens LA, Labreche M, Piazza G, Catapane E, Novack L, Goldhaber SZ. Adherence to pharmacological thromboprophylaxis orders in hospitalized patients. Am J Med. In press.Google Scholar16 McDonald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions: scientific review. JAMA. 2002; 288: 2868–2879.CrossrefMedlineGoogle Scholar17 Schroeder K, Fahey T, Ebrahim S. How can we improve adherence to blood pressure-lowering medication in ambulatory care? Systematic review of randomized controlled trials. Arch Intern Med. 2004; 164: 722–732.CrossrefMedlineGoogle Scholar18 Schnipper JL, Kirwin JL, Cotugno MC, Wahlstrom SA, Brown BA, Tarvin E, Kachalia A, Horng M, Roy CL, McKean SC, Bates DW. Role of pharmacist counseling in preventing adverse drug events after hospitalization. Arch Intern Med. 2006; 166: 565–571.CrossrefMedlineGoogle Scholar19 Svensson S, Kjellgren KI, Ahlner J, Saljo R. Reasons for adherence with antihypertensive medication. Int J Cardiol. 2000; 76: 157–163.CrossrefMedlineGoogle Scholar Previous Back to top Next FiguresReferencesRelatedDetailsCited By Shiyanbola O, Rao D, Kuehl S, Bolt D, Ward E and Brown C (2022) Psychometric evaluation of a culturally adapted illness perception questionnaire for African Americans with type 2 diabetes, BMC Public Health, 10.1186/s12889-022-13172-2, 22:1, Online publication date: 1-Dec-2022. Rattanavipanon W, Chaiyasothi T, Puchsaka P, Mungkornkaew R, Nathisuwan S, Veettil S and Chaiyakunapruk N (2022) Effects of pharmacist interventions on cardiovascular risk factors and outcomes: An umbrella review of meta‐analysis of randomized controlled trials, British Journal of Clinical Pharmacology, 10.1111/bcp.15279, 88:7, (3064-3077), Online publication date: 1-Jul-2022. He Q, Zheng J, Liu J, Wang J and You L (2020) Predictors of Medication Adherence of Patients With Coronary Heart Disease After Percutaneous Coronary Intervention, Journal of Cardiovascular Nursing, 10.1097/JCN.0000000000000755, 37:4, (350-358), Online publication date: 1-Jul-2022. Lasala R and Santoleri F (2021) Association between adherence to oral therapies in cancer patients and clinical outcome: A systematic review of the literature, British Journal of Clinical Pharmacology, 10.1111/bcp.15147, 88:5, (1999-2018), Online publication date: 1-May-2022. Krøll J, Butt J, Jensen H, Fosbøl E, Camilla H, Winkel B, Kanters J, Gislason G, Torp-Pedersen C, Køber L, Bundgaard H, Tfelt-Hansen J and Weeke P (2022) β-blocker adherence among patients with congenital long QT syndrome: a nationwide study, European Heart Journal - Quality of Care and Clinical Outcomes, 10.1093/ehjqcco/qcac017 Nakwafila O, Mashamba-Thompson T, Godi A and Sartorius B (2022) A Cross-Sectional Study on Hypertension Medication Adherence in a High-Burden Region in Namibia: Exploring Hypertension Interventions and Validation of the Namibia Hill-Bone Compliance Scale, International Journal of Environmental Research and Public Health, 10.3390/ijerph19074416, 19:7, (4416) Roy A, Peterson A, Marchant N, Alvir J, Bhambri R, Lynn J, Benjumea D, Prasad S, O'Brien A, Chen Y, Kemner J and Parasuraman B (2022) Baseline Characteristics and Secondary Medication Adherence Patterns Among Patients Receiving Tafamidis Prescriptions: A Retrospective Analysis Using a National Specialty Pharmacy Dispensing Database, Patient Preference and Adherence, 10.2147/PPA.S352332, Volume 16, (1115-1129) Batista Santos V, Lima Silva L, Guizilini S, Begot Valente I, Bublitz Barbosa C, Batistalto Carneiro T and Lopes Moreira R (2022) Adherencia a la terapia antiplaquetaria y a las estatinas por pacientes con síndrome coronario agudo tras el alta, Enfermería Clínica, 10.1016/j.enfcli.2020.02.020, 32:2, (115-122), Online publication date: 1-Mar-2022. Batista Santos V, Lima Silva L, Guizilini S, Begot Valente I, Bublitz Barbosa C, Batistalto Carneiro T and Lopes Moreira R (2022) Adherencia a la terapia antiplaquetaria y a las estatinas por pacientes con síndrome coronario agudo tras el alta, Enfermería Clínica (English Edition), 10.1016/j.enfcle.2020.02.005, 32:2, (115-122), Online publication date: 1-Mar-2022. Horne B, Muhlestein J, Lappé D, May H, Le V, Bair T, Babcock D, Bride D, Knowlton K and Anderson J (2022) Behavioral Nudges as Patient Decision Support for Medication Adherence: The ENCOURAGE Randomized Controlled Trial, American Heart Journal, 10.1016/j.ahj.2021.11.001, 244, (125-134), Online publication date: 1-Feb-2022. Piekarz H, Langran C and Donyai P (2021) A phenomenological analysis of the experience of taking medication to prevent a further heart attack, Scientific Reports, 10.1038/s41598-021-02909-5, 11:1, Online publication date: 1-Dec-2021. Aubeeluck E, Al‐Arkee S, Finlay K and Jalal Z (2021) The impact of pharmacy care and motivational interviewing on improving medication adherence in patients with cardiovascular diseases: A systematic review of randomised controlled trials, International Journal of Clinical Practice, 10.1111/ijcp.14457, 75:11, Online publication date: 1-Nov-2021. Spatola C, Giusti E, Rapelli G, Goodwin C, Cattivelli R, Pietrabissa G, Malfatto G, Facchini M, Castelnuovo G and Molinari E (2021) Cardiac‐specific experiential avoidance predicts change in general psychological well‐being among patients completing cardiac rehabilitation, Applied Psychology: Health and Well-Being, 10.1111/aphw.12260, 13:4, (715-727), Online publication date: 1-Nov-2021. Z Malak M, J Al-thbetat A and M AL-Amer R (2021) Psychosocial factors correlate with adherence to medications among cardiovascular outpatient clinics in Jordan, Journal of Public Health, 10.1093/pubmed/fdab356 McIntyre W, Belesiotis P, McClure G, Demers C, Chahill G, Hayes A, Sohi G, Bordman W, Whitlock R and Belley-Côté E (2020) Strategies to Reduce Out-of-Pocket Medication Costs for Canadians Living with Heart Failure, Cardiovascular Drugs and Therapy, 10.1007/s10557-020-07046-1, 35:5, (1009-1023), Online publication date: 1-Oct-2021. Yoshihiro S, Tomita T, Sakuraya M, Onozuka K and Hashimoto Y (2021) Factors predicting the inability to self-manage medication after discharge from the intensive care unit: a retrospective cohort study集中治療室退室後患者の医薬品自己管理能力を推定する要因調査:単施設後ろ向き研究, Journal of the Japanese Society of Intensive Care Medicine, 10.3918/jsicm.28_437, 28:5, (437-443), Online publication date: 1-Sep-2021. Kernan W, Viera A, Billinger S, Bravata D, Stark S, Kasner S, Kuritzky L and Towfighi A (2021) Primary Care of Adult Patients After Stroke: A Scientific Statement From the American Heart Association/American Stroke Association, Stroke, 52:9, (e558-e571), Online publication date: 1-Sep-2021. Stabile E, Franzese M, Chianese S, Alfani A, Gerardi D, Colaiori I, Annunziata M, Nappi P, Scalise M, Di Serafino L, Puzone B, Avvedimento M, Leone A, Ilardi F, Piccolo R, Franzone A, Cirillo P, Morisco C, Trimarco B and Esposito G (2021) Predictors of adherence to composite therapy after acute coronary syndromes, Journal of Cardiovascular Medicine, 10.2459/JCM.0000000000001201, 22:8, (645-651), Online publication date: 1-Aug-2021. Martin-Latry K, Latry P, Pucheu Y and Couffinhal T (2021) Validation d'une échelle de mesure de l'adhésion médicamenteuse cardiovasculaire utilisable en contexte hospitalier, Annales Pharmaceutiques Françaises, 10.1016/j.pharma.2020.11.008, 79:4, (457-464), Online publication date: 1-Jul-2021. Hajialibeigloo R, Mazlum S, Mohajer S and Morisky D (2021) Effect of self‐administration of medication programme on cardiovascular inpatients' medication adherence and nurses' satisfaction: A randomized clinical trial, Nursing Open, 10.1002/nop2.870, 8:4, (1947-1957), Online publication date: 1-Jul-2021. Alves-Silva J, Zuzarte M, Girão H and Salgueiro L (2021) The Role of Essential Oils and Their Main Compounds in the Management of Cardiovascular Disease Risk Factors, Molecules, 10.3390/molecules26123506, 26:12, (3506) Alalaqi A, Lawson G, Obaid Y, Tanna S and Thakur S (2021) Adherence to cardiovascular pharmacotherapy by patients in Iraq: A mixed methods assessment using quantitative dried blood spot analysis and the 8-item Morisky Medication Adherence Scale, PLOS ONE, 10.1371/journal.pone.0251115, 16:5, (e0251115) Padilla López A, Alós-Almiñana M and Peris J (2020) Health Outcomes and Primary Adherence to Secondary Prevention Treatment after St-Elevation Myocardial Infarction: a Spanish Cohort Study, Journal of Cardiovascular Translational Research, 10.1007/s12265-020-10045-0, 14:2, (308-316), Online publication date: 1-Apr-2021. Sederholm Lawesson S, Swahn E and Alfredsson J (2021) Adherence to Study Drugs, Circulation, 143:7, (696-698), Online publication date: 16-Feb-2021. Al-Asmari A, Aljohani K and Aloufi M (2021) Prevalence and predictors of medication adherence among adult cardiovascular diseases patients in al-Madinah, Saudi Journal for Health Sciences, 10.4103/sjhs.sjhs_206_20, 10:3, (178), . Fetensa G, Fekadu G, Turi E, Tolossa T, Wakuma B, Etefa W, Habte A, Yadecha B and Bekele F (2021) Self-care behaviour and associated factors among chronic heart failure clients on follow up at selected hospitals of Wollega zones, Ethiopia, International Journal of Africa Nursing Sciences, 10.1016/j.ijans.2021.100355, 15, (100355), . Rapelli G, Donato S, Bertoni A, Spatola C, Pagani A, Parise M and Castelnuovo G (2019) The Combined Effect of Psychological and Relational Aspects on Cardiac Patient Activation, Journal of Clinical Psychology in Medical Settings, 10.1007/s10880-019-09670-y, 27:4, (783-794), Online publication date: 1-Dec-2020. Han J, Zhang Y, No G and Urmie J (2020) Medication adherence among chronic condition patients in the Medicaid coverage gap, Research in Social and Administrative Pharmacy, 10.1016/j.sapharm.2019.11.011, 16:7, (982-986), Online publication date: 1-Jul-2020. Alifer O (2020) CHANGES OF LIFE QUALITY SCORE DEPENDING ON THE ARTERIAL HYPERTENSION DEGREE IN THE GENDER ASPECT, Medical Science of Ukraine (MSU), 10.32345/2664-4738.2.2020.3, 16:2, (16-22) Di Lorenzo R, Perrone D, Montorsi A, Balducci J, Rovesti S and Ferri P (2020) Attitude Towards Drug Therapy in a Community Mental Health Center Evaluated by the Drug Attitude Inventory, Patient Preference and Adherence, 10.2147/PPA.S251993, Volume 14, (995-1010) Ma J and Wang L (2018) Characteristics of Mail-Order Pharmacy Users: Results From the Medical Expenditures Panel Survey, Journal of Pharmacy Practice, 10.1177/0897190018800188, 33:3, (293-298), Online publication date: 1-Jun-2020. Williams B, Masi S, Wolf J and Schmieder R (2020) Facing the Challenge of Lowering Blood Pressure and Cholesterol in the Same Patient: Report of a Symposium at the European Society of Hypertension, Cardiology and Therapy, 10.1007/s40119-019-00159-1, 9:1, (19-34), Online publication date: 1-Jun-2020. Speck L, Furze G and Brace N (2020) Health Behaviour Change and Education Cardiovascular Prevention and Rehabilitation in Practice, 10.1002/9781119071006.ch4, (67-97), Online publication date: 30-Mar-2020. Fanaroff A, Peterson E, Kaltenbach L, Cannon C, Choudhry N, Henry T, Anstrom K, Cohen D, Fonseca E, Khan N, Fonarow G and Wang T (2020) Association of a P2Y 12 Inhibitor Copayment Reduction Intervention With Persistence and Adherence With Other Secondary Prevention Medications , JAMA Cardiology, 10.1001/jamacardio.2019.4408, 5:1, (38), Online publication date: 1-Jan-2020. Reading S, Black M, Singer D, Go A, Fang M, Udaltsova N, Harrison T, Wei R, Liu I and Reynolds K (2019) Risk factors for medication non-adherence among atrial fibrillation patients, BMC Cardiovascular Disorders, 10.1186/s12872-019-1019-1, 19:1, Online publication date: 1-Dec-2019. Lauffenburger J, Acri T and Gross R (2019) Studies of Medication Adherence Pharmacoepidemiology, 10.1002/9781119413431.ch38, (991-1009), Online publication date: 6-Nov-2019. Wawruch M, Wimmer G, Murin J, Paduchova M, Tesar T, Hlinkova L, Slavkovsky P, Fabryova L and Aarnio E (2019) Patient-Associated Characteristics Influencing the Risk for Non-Persistence with Statins in Older Patients with Peripheral Arterial Disease, Drugs & Aging, 10.1007/s40266-019-00689-2, 36:9, (863-873), Online publication date: 1-Sep-2019. O'Connor A, Ladebue A, Peterson J, Davis R, Jung Grant S, McCreight M and Lambert-Kerzner A (2018) Creating and testing regulatory focus messages to enhance medication adherence, Chronic Illness, 10.1177/1742395317753882, 15:2, (124-137), Online publication date: 1-Jun-2019. Amarilyo G, Chodick G, Zalcman J, Koren G, Levinsky Y, Somekh I and Harel L (2019) Poor long-term adherence to secondary penicillin prophylaxis in children with history of rheumatic fever, Seminars in Arthritis and Rheumatism, 10.1016/j.semarthrit.2018.10.015, 48:6, (1019-1024), Online publication date: 1-Jun-2019. Lauffenburger J, Khan N, Brill G and Choudhry N (2018) Quantifying Social Reinforcement Among Family Members on Adherence to Medications for Chronic Conditions: a US-Based Retrospective Cohort Study, Journal of General Internal Medicine, 10.1007/s11606-018-4654-9, 34:6, (855-861), Online publication date: 1-Jun-2019. Doggrell S (2019) A review of interventions ≥ 6 months by pharmacists on adherence to medicines in cardiovascular disease: Characteristics of what works and what doesn't, Research in Social and Administrative Pharmacy, 10.1016/j.sapharm.2018.04.003, 15:2, (119-129), Online publication date: 1-Feb-2019. McCreight M, Lambert-Kerzner A, O'Donnell C, Grunwald G, Hebert P, Gillette M, Jneid H, Parashar A, Grossman P, Helfrich C, Mavromatis K, Saket G and Ho P (2019) Improving anti-platelet therapy adherence in the Veterans Health Administration: A randomized multi-site hybrid effectiveness-implementation study protocol, Contemporary Clinical Trials, 10.1016/j.cct.2018.12.005, 77, (104-110), Online publication date: 1-Feb-2019. Doll J, Hellkamp A, Thomas L, Fonarow G, Peterson E and Wang T (2019) The association of pre- and posthospital medication adherence in myocardial infarction patients, American Heart Journal, 10.1016/j.ahj.2018.11.004, 208, (74-80), Online publication date: 1-Feb-2019. Colantonio L, Rosenson R, Deng L, Monda K, Dai Y, Farkouh M, Safford M, Philip K, Mues K and Muntner P (2019) Adherence to Statin Therapy Among US Adults Between 2007 and 2014, Journal of the American Heart Association, 8:1, Online publication date: 8-Jan-2019. Shepeleva E, Lapteva N, Mukhorina A, Bogdanova R and Syrkina E (2019) Socio-demographic factors of commitment to treatment in atrial fibrillation: a psychologist's view, Journal of Modern Foreign PsychologyСовременная зарубежная психология, 10.17759/jmfp.2019080309, 8:3, (87) Sokolova N (2019) Adherence to therapy in patients with stable coronary artery disease after various revascularization procedures, Kardiologiya i serdechno-sosudistaya khirurgiya, 10.17116/kardio20191201125, 12:1, (25), . Meetoo D, Rylance R and Abuhaimid H (2018) Health care in a technological world, British Journal of Nursing, 10.12968/bjon.2018.27.20.1172, 27:20, (1172-1177), Online publication date: 8-Nov-2018. David G, Saynisch P, Luster S, Smith-McLallen A and Chawla R (2018) The impact of patient-centered medical homes on med
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