title: Medication adherence in patients after percutaneous coronary intervention due to acute myocardial infarction: From research to clinical implications.
abstract: Adherence to medication is one of the most significant challenges of secondary prevention in patients after an acute myocardial infarction (AMI). Indeed, it has been well established that higher adherence is associated with better cardiovascular outcomes. Research pertaining to secondary prevention after AMI treated with percutaneous coronary intervention (PCI) focuses mainly on the adherence to antiplatelet therapy. Adherence levels have been found to be particularly poor and thus, insufficient with regards to prevention; with a high rate of discontinuation of therapy occurring during the 12-month follow-up. There are numerous predicting factors associated with non-adherence to antiplatelet therapy in patients after PCI. These include, but are not limited to, a lack of education on antiplatelet treatment, various comorbidities, depression, or even, unmarried status. Financial limitations of the patient also play a relevant role, however, the nature of this impediment is problematic and requires further investigation. It would seem beneficial to carry out advanced research based on a randomized and double-blind protocol, however, large-cohort, real-world observations are also essential to investigate non-adherence across a broad array of treatment settings above and beyond the scope of prospective clinical trials. Research about adherence under the context of invasive treatment of AMI has a tremendous practical impact and should be considered a matter of importance concerning both clinicians and scientists. Close collaboration between not only researchers, health practitioners, i.e. physicians and pharmacists, but also politicians, is strongly recommended to aid in designing an intervention that might improve patient adherence.
authors.affiliation: 1st Department of Cardiology, Medical University of Gdansk, Poland. d.swieczkowski@gumed.edu.pl.
authors.forename: Damian
authors.initials: D
authors.lastname: Swieczkowski
authors.affiliation: Research & Development Laboratory, OCEANIC S.A., Poland.
authors.forename: Mariusz
authors.initials: M
authors.lastname: Mogielnicki
authors.affiliation: First Department of Cardiology, Medical University of Gdansk, Poland.
authors.forename: Natalia
authors.initials: N
authors.lastname: Cwalina
authors.affiliation: First Department of Cardiology, Medical University of Gdansk, Poland.
authors.forename: Grzegorz
authors.initials: G
authors.lastname: Zuk
authors.affiliation: First Department of Cardiology, Medical University of Gdansk, Poland.
authors.forename: Izabela
authors.initials: I
authors.lastname: Pisowodzka
authors.affiliation: First Department of Cardiology, Medical University of Gdansk, Poland.
authors.forename: Dariusz
authors.initials: D
authors.lastname: Ciecwierz
authors.affiliation: First Department of Cardiology, Medical University of Gdansk, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Gruchala
authors.affiliation: First Department of Cardiology, Medical University of Gdansk, Poland.
authors.forename: Milosz
authors.initials: M
authors.lastname: Jaguszewski
keywords: acute coronary syndrome; compliance; medication adherence; myocardial infarction; percutaneous coronary intervention; platelet aggregation inhibitors