title: Optimal pharmacological treatment and adherence to medication in secondary prevention of cardiovascular events in Spain: Results from the CAPS study.
abstract: BACKGROUND
  Despite the large amount of evidence supporting the use of antiplatelet agents, beta-blockers, angiotensin antagonists, and lipid-lowering statins in patients with stable coronary artery disease, several studies have documented underprescription of optimal medical treatment (OMT) in Spain.
  
  
  OBJECTIVE
  The present study aimed to describe the current trend of pharmacological prescription in secondary prevention treatment for cardiovascular diseases (CVDs) in a Spanish cohort.
  
  
  METHODS
  This study was a multicenter, observational, cross-sectional study (CAPS study, FER-CAR-2014-01) in the context of only one visit. Adherence levels to the prescribed medication, the reasons for not prescription of each medication, the existence of possible associations between sociodemographic features, different CVDs, and different drugs with treatment compliance were also analyzed in patients who have suffered cardiovascular effects.
  
  
  RESULTS
  Six hundred and twelve patients (68.5±10.7 years old; 78% males) were included. OMT was prescribed in 40.8% of the patients. The main reason for not prescribing was due to the physician's discretion. Adherence to medication, measured by the Morisky-Green questionnaire, was 45.8%, and it was positively related to the presence of coronary events (OR 1.80; 95% CI: 1.05-3.21) but not with any drug type. Moreover, a higher educational background implied a higher percentage of adherence to medication. Finally, nonadherent patients were prescribed more daily medicine intakes.
  
  
  CONCLUSIONS
  Low adherence to guideline-oriented treatment as well as low adherence to medication was found by a self-reported questionnaire. Enhancing adherence to guideline-recommended therapy and reducing treatment complexity seem to be reasonable strategies to improve adherence to secondary prevention medications.
authors.affiliation: Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Cordero
authors.affiliation: Cardiology Department, Hospital de Toledo, Toledo, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: Rodriguez Padial
authors.affiliation: Department of Cardiology, Clínica Cardiológica Dr. Batalla, Gijón, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Batalla
authors.affiliation: Centro Nacional de Investigaciones Cardiovasculares, Madrid, grupo HM, Hospital Universitario Monteprincipe, Madrid, Spain.
authors.forename: Luis
authors.initials: L
authors.lastname: López Barreiro
authors.affiliation: Centro Nacional de Investigaciones Cardiovasculares, Madrid, grupo HM, Hospital Universitario Monteprincipe, Madrid, Spain.
authors.forename: Francisco
authors.initials: F
authors.lastname: Torres Calvo
authors.affiliation: Centro Nacional de Investigaciones Cardiovasculares, Madrid, grupo HM, Hospital Universitario Monteprincipe, Madrid, Spain.
authors.forename: Jose M
authors.initials: JM
authors.lastname: Castellano
authors.affiliation: Medical Department, Ferrer, Barcelona, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Ruiz
authors.affiliation: Cardiology Department, Hospital Universitario de San Juan, Alicante, Spain.
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu-Martínez
mesh_terms: D000368:Aged; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D019338:Polypharmacy; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D012008:Recurrence; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods* / Q000592:standards / Q000639:trends; D012959:Socioeconomic Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D002317:Cardiovascular Agents; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Adherence; Cardiovascular; Optimal treatment; Secondary prevention