Discontinuation of secondary prevention medication after myocardial infarction – the role of general practitioners and patients
BACKGROUND: Despite the significant benefits of secondary prevention (SP) medication after acute myocardial infarction (MI), evidence suggests that these medications are neither consistently prescribed nor appropriately adhered to by patients. The aim of this study was to investigate the role...
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| Format: | Article |
| Language: | English |
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SMW supporting association (Trägerverein Swiss Medical Weekly SMW)
2013-11-01
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| Series: | Swiss Medical Weekly |
| Subjects: | |
| Online Access: | https://www.smw.ch/index.php/smw/article/view/1770 |
| _version_ | 1798003661471744000 |
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| author | Klaus Bally Ronny Buechel Peter Buser Benedict Martina Peter Tschudi Andreas Zeller |
| author_facet | Klaus Bally Ronny Buechel Peter Buser Benedict Martina Peter Tschudi Andreas Zeller |
| author_sort | Klaus Bally |
| collection | DOAJ |
| description |
BACKGROUND: Despite the significant benefits of secondary prevention (SP) medication after acute myocardial infarction (MI), evidence suggests that these medications are neither consistently prescribed nor appropriately adhered to by patients. The aim of this study was to investigate the role of general practitioners (GPs) and patients regarding discontinuation of SP medication after MI and reasons for discontinuation.
METHODS: In this observational study, GPs of patients who had suffered acute MI provided information on discontinuation of SP medication 6 and 12 months after hospital discharge. A questionnaire-based approach was used (a) to assess the consistent use of SP medication after MI, (b) to determine reasons for stopping SP medication, (c) to quantify the involvement of GPs and patients regarding discontinuation, and (d) to analyse potential factors that are associated with discontinuation of medication.
RESULTS: Of 204 subjects 6 and 12 months after hospital discharge 83% and 75% patients, respectively, were still on recommended SP medication. Overall, one or more SP medications were stopped (53 medications) or modified (15 medications) in 52 (25%) patients. Adverse side effects were the main reason for stopping medication (63%). GPs reported being responsible for initiating discontinuation or modification more frequently than patients (62% vs 38%, p = 0.065).
CONCLUSION: The consistent use of evidence-based pharmacotherapy 6 and 12 months after myocardial infarction was adequate. Three out of four patients were still on recommended SP medication after 1 year of follow-up. Two-thirds of medication discontinuations were initiated by GPs, predominantly because of side effects.
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| first_indexed | 2024-04-11T12:11:20Z |
| format | Article |
| id | doaj.art-0826b45d45c74fa09e6aeb35e2d16f39 |
| institution | Directory Open Access Journal |
| issn | 1424-3997 |
| language | English |
| last_indexed | 2024-04-11T12:11:20Z |
| publishDate | 2013-11-01 |
| publisher | SMW supporting association (Trägerverein Swiss Medical Weekly SMW) |
| record_format | Article |
| series | Swiss Medical Weekly |
| spelling | doaj.art-0826b45d45c74fa09e6aeb35e2d16f392022-12-22T04:24:36ZengSMW supporting association (Trägerverein Swiss Medical Weekly SMW)Swiss Medical Weekly1424-39972013-11-01143454610.4414/smw.2013.13896Discontinuation of secondary prevention medication after myocardial infarction – the role of general practitioners and patientsKlaus BallyRonny BuechelPeter BuserBenedict MartinaPeter TschudiAndreas Zeller BACKGROUND: Despite the significant benefits of secondary prevention (SP) medication after acute myocardial infarction (MI), evidence suggests that these medications are neither consistently prescribed nor appropriately adhered to by patients. The aim of this study was to investigate the role of general practitioners (GPs) and patients regarding discontinuation of SP medication after MI and reasons for discontinuation. METHODS: In this observational study, GPs of patients who had suffered acute MI provided information on discontinuation of SP medication 6 and 12 months after hospital discharge. A questionnaire-based approach was used (a) to assess the consistent use of SP medication after MI, (b) to determine reasons for stopping SP medication, (c) to quantify the involvement of GPs and patients regarding discontinuation, and (d) to analyse potential factors that are associated with discontinuation of medication. RESULTS: Of 204 subjects 6 and 12 months after hospital discharge 83% and 75% patients, respectively, were still on recommended SP medication. Overall, one or more SP medications were stopped (53 medications) or modified (15 medications) in 52 (25%) patients. Adverse side effects were the main reason for stopping medication (63%). GPs reported being responsible for initiating discontinuation or modification more frequently than patients (62% vs 38%, p = 0.065). CONCLUSION: The consistent use of evidence-based pharmacotherapy 6 and 12 months after myocardial infarction was adequate. Three out of four patients were still on recommended SP medication after 1 year of follow-up. Two-thirds of medication discontinuations were initiated by GPs, predominantly because of side effects. https://www.smw.ch/index.php/smw/article/view/1770acute myocardial infarctionevidence based medicineprimary health caresecondary prevention |
| spellingShingle | Klaus Bally Ronny Buechel Peter Buser Benedict Martina Peter Tschudi Andreas Zeller Discontinuation of secondary prevention medication after myocardial infarction – the role of general practitioners and patients Swiss Medical Weekly acute myocardial infarction evidence based medicine primary health care secondary prevention |
| title | Discontinuation of secondary prevention medication after myocardial infarction – the role of general practitioners and patients |
| title_full | Discontinuation of secondary prevention medication after myocardial infarction – the role of general practitioners and patients |
| title_fullStr | Discontinuation of secondary prevention medication after myocardial infarction – the role of general practitioners and patients |
| title_full_unstemmed | Discontinuation of secondary prevention medication after myocardial infarction – the role of general practitioners and patients |
| title_short | Discontinuation of secondary prevention medication after myocardial infarction – the role of general practitioners and patients |
| title_sort | discontinuation of secondary prevention medication after myocardial infarction the role of general practitioners and patients |
| topic | acute myocardial infarction evidence based medicine primary health care secondary prevention |
| url | https://www.smw.ch/index.php/smw/article/view/1770 |
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