Adherence to secondary prevention therapies in acute coronary syndrome.
Despite overwhelming evidence of the effectiveness of secondary prevention therapies, surveys indicate poor adherence to medical treatments and lifestyle recommendations after an acute coronary syndrome. The term adherence is preferred over compliance, as the former suggests a therapeutic alliance, whereas the latter reflects passive patient obedience. Poor adherence results from a complex interplay of multiple factors at patient, practitioner and system levels. Poor adherence among patients with stable coronary artery disease is associated with increased risk of cardiovascular admissions (10%-40%), coronary interventions (10%-30%) and cardiovascular mortality (50%-80%). Improving adherence is a complex process. A range of interventions that target modifiable factors influencing adherence have been explored, but there are no guidelines to guide the choice, and multidisciplinary efforts may be needed. Future research in the area should focus on comparative efficacy of interventions to enhance adherence.
Department of Cardiology, Westmead Hospital, Sydney, NSW, Australia. drjaythakkar@yahoo.com.au.
Jay B
JB
Thakkar
Cardiac Program, The George Institute for Global Health, University of Sydney, Sydney, NSW, Australia.
Clara K
CK
Chow
D054058:Acute Coronary Syndrome / Q000517:prevention & control*; D003376:Counseling; D015438:Health Behavior; D006801:Humans; D000960:Hypolipidemic Agents / Q000008:administration & dosage; D010349:Patient Compliance / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D055502:Secondary Prevention; D016896:Treatment Outcome
D000960:Hypolipidemic Agents