Jeannette Y. Wick, RPh, MBA, FASCP
Among patients admitted to the hospital with acute coronary syndrome, women and black patients expressed increased concerns about aspirin therapy, which was correlated with lower adherence.
Aspirin is a key intervention in patients who have acute coronary syndrome (ACS), and adherence to a regimen of daily aspirin reduces morbidity and mortality. However, new findings have revealed that patients who experience an episode of ACS are often nonadherent to medication regimens because they worry about side effects and long-term effects associated with specific medications.
A team of researchers presented data
regarding predictors of medication concern and aspirin non-adherence in patients with ACS on March 9, 2013, at the American College of Cardiology Scientific Session. The researchers surveyed 510 patients who had been admitted to the hospital for ACS by phone after discharge. They took brief drug histories using the Morisky Scale, which includes 6 to 8 questions about past medication use patterns and is frequently used to measure medication adherence in patients with cardiovascular disease.
The researchers also used the Belief in Medication Questionnaire (BMQ) to determine whether patients had concerns about aspirin therapy and whether they understood why it was necessary. They measured adherence against age, concern, gender, black race, Hispanic ethnicity, and education level.
The results indicated that only the BMQ concern score was significantly associated with aspirin adherence. As patients’ concern scores increased, self-reported adherence decreased. In addition, medication concern was elevated in women and patients of black race compared with all others. Age, education, ethnicity, and BMQ understanding of necessity score did not correlate with increased concern.
Pharmacists can use these finding during counseling: Asking whether patients have concerns about medication in general and aspirin in particular can help identify those who need additional support. Ensuring that patients understand how important post-ACS medication therapy is has the potential to improve adherence. In addition, understanding that patients with certain demographic characteristics are apt to need more targeted intervention can help reduce health disparities.
Ms. Wick is a visiting professor at the University of Connecticut School of Pharmacy and a freelance writer from Virginia.