ADHERENCIAADHERENCIA

Enrique Otero ChulianUGC Cardiologiacutea

DIacuteA MUNDIAL DEL CORAZOacuteN 2015

Los medicamientos no funcionanhellip

hellipen aquellos pacientes que no los toman

Dr Evert Koop

CONCEPTO ADHERENCIACONCEPTO ADHERENCIA

bull Proporcioacuten de pacientes que al menos tienen el 75 de los diacuteas cubiertos por los faacutermacos prescritos en un tiempo determinado seguacuten lo recetado

Naderi et al Adherence to drugs that prevent cardiovascular disease meta-nalysis on 376162 patients Am J med 2012125882-7

Problemas de adherencia en prevencioacuten secundaria

Jackevicius CA JAMA 2002

Un 20 de los pacientes croacutenicos no inicia el tratamiento prescrito

Un 50 de pacientes ha abandonado el tratamiento a los 6 meses

McHorney Curr Med Res Opin 2009

El 34 de los pacientes interrumpe el tratamiento de al menos 1 de los faacutermacos y el 12 el de los 3 faacutermacos en el primer mes posterior al alta hospitalaria1

El 24 de los pacientes no cumplen el tratamiento 7 diacuteas despueacutes del alta tras un infarto de miocardio1

7 diacuteas despueacutes

1 de los farmacos

Los 3 farmacos

De las Guiacuteas a la Praacutectica Cliacutenica

ADHERENCIAADHERENCIA

Indicacioacuten de la polipiacuteldoraIndicacioacuten de la polipiacuteldora

bull Prevencioacuten secundaria de accidentes cardiovasculares como tratamiento de sustitucioacuten en pacientes adultos controlados de forma adecuada con los monocomponentes administrados concomitantemente en dosis terapeacuteuticas equivalentes

Conclusiones POLIPILDORAConclusiones POLIPILDORA

bull Con el tratamiento con polipiacuteldora CNIC-FS-Ferrer

aumenta 22 relativo el porcentaje de pacientes

adherentes a la medicacioacuten en pacientes post IAM de

larga evolucioacuten y que teniacutean una baja adherencia basal

bull La polipiacuteldora CNIC-FS-Ferrer es un tratamiento seguro

en estos pacientes tras 9 meses de seguimiento

2 Tratamiento meacutedico ADHERENCIAAm J Med 2009 Oct122(10)961e7-13 doi 101016jamjmed200812021 Epub 2009 Jun 26Long-term medication adherence after myocardial infarction experience of a communityShah ND Dunlay SM Ting HH Montori VM Thomas RJ Wagie AE Roger VLSourceDivision of Health Care Policy and Research Mayo Clinic College of Medicine Rochester MN 55905 USA shahnilaymayoeduAbstractBACKGROUNDAdherence to evidence-based medications after myocardial infarction is associated with improved outcomes However long-term data on factors affecting medication adherence after myocardial infarction are lackingMETHODSOlmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified Adherence to HMG-CoA reductase inhibitors (statins) beta blockers angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were examined Cox proportional hazard regression was used to determine the factors associated with medication adherence over timeRESULTSAmong 292 subjects with incident myocardial infarction (63 men mean age 65 years) patients were followed for an average of 52+-31 months Adherence to guideline-recommended medications decreased over time with 3-year medication continuation rates of 44 48 and 43 for statins beta-blockers and angiotensin-converting enzyme inhibitorsangiotensin II receptor blockers respectively Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications with adjusted hazard ratio (95 confidence interval) for discontinuation of statins and beta-blockers among cardiac rehabilitation participants of 066 (045-092) and 070 (049-098) respectively Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications although results did not reach statistical significance There were no observed associations between demographic characteristics clinical characteristics of the myocardial infarction and medication adherenceCONCLUSIONSAfter myocardial infarction a large proportion of patients discontinue use of medications over time Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherencePMID 19560749 [PubMed - indexed for MEDLINE]

CONCLUSIONES Despueacutes de un infarto un nuacutemero elevado de pacientes abandonan la medicacioacutenhellipy su inclusioacuten en un programa de Rehabilitacioacuten Cardiacuteaca incrementa la adherencia

Los medicamientos no funcionanhellip

hellipen aquellos pacientes que no los toman

Dr Evert Koop

CONCEPTO ADHERENCIACONCEPTO ADHERENCIA

bull Proporcioacuten de pacientes que al menos tienen el 75 de los diacuteas cubiertos por los faacutermacos prescritos en un tiempo determinado seguacuten lo recetado

Naderi et al Adherence to drugs that prevent cardiovascular disease meta-nalysis on 376162 patients Am J med 2012125882-7

Problemas de adherencia en prevencioacuten secundaria

Jackevicius CA JAMA 2002

Un 20 de los pacientes croacutenicos no inicia el tratamiento prescrito

Un 50 de pacientes ha abandonado el tratamiento a los 6 meses

McHorney Curr Med Res Opin 2009

El 34 de los pacientes interrumpe el tratamiento de al menos 1 de los faacutermacos y el 12 el de los 3 faacutermacos en el primer mes posterior al alta hospitalaria1

El 24 de los pacientes no cumplen el tratamiento 7 diacuteas despueacutes del alta tras un infarto de miocardio1

7 diacuteas despueacutes

1 de los farmacos

Los 3 farmacos

De las Guiacuteas a la Praacutectica Cliacutenica

ADHERENCIAADHERENCIA

Indicacioacuten de la polipiacuteldoraIndicacioacuten de la polipiacuteldora

bull Prevencioacuten secundaria de accidentes cardiovasculares como tratamiento de sustitucioacuten en pacientes adultos controlados de forma adecuada con los monocomponentes administrados concomitantemente en dosis terapeacuteuticas equivalentes

Conclusiones POLIPILDORAConclusiones POLIPILDORA

bull Con el tratamiento con polipiacuteldora CNIC-FS-Ferrer

aumenta 22 relativo el porcentaje de pacientes

adherentes a la medicacioacuten en pacientes post IAM de

larga evolucioacuten y que teniacutean una baja adherencia basal

bull La polipiacuteldora CNIC-FS-Ferrer es un tratamiento seguro

en estos pacientes tras 9 meses de seguimiento

2 Tratamiento meacutedico ADHERENCIAAm J Med 2009 Oct122(10)961e7-13 doi 101016jamjmed200812021 Epub 2009 Jun 26Long-term medication adherence after myocardial infarction experience of a communityShah ND Dunlay SM Ting HH Montori VM Thomas RJ Wagie AE Roger VLSourceDivision of Health Care Policy and Research Mayo Clinic College of Medicine Rochester MN 55905 USA shahnilaymayoeduAbstractBACKGROUNDAdherence to evidence-based medications after myocardial infarction is associated with improved outcomes However long-term data on factors affecting medication adherence after myocardial infarction are lackingMETHODSOlmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified Adherence to HMG-CoA reductase inhibitors (statins) beta blockers angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were examined Cox proportional hazard regression was used to determine the factors associated with medication adherence over timeRESULTSAmong 292 subjects with incident myocardial infarction (63 men mean age 65 years) patients were followed for an average of 52+-31 months Adherence to guideline-recommended medications decreased over time with 3-year medication continuation rates of 44 48 and 43 for statins beta-blockers and angiotensin-converting enzyme inhibitorsangiotensin II receptor blockers respectively Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications with adjusted hazard ratio (95 confidence interval) for discontinuation of statins and beta-blockers among cardiac rehabilitation participants of 066 (045-092) and 070 (049-098) respectively Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications although results did not reach statistical significance There were no observed associations between demographic characteristics clinical characteristics of the myocardial infarction and medication adherenceCONCLUSIONSAfter myocardial infarction a large proportion of patients discontinue use of medications over time Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherencePMID 19560749 [PubMed - indexed for MEDLINE]

CONCLUSIONES Despueacutes de un infarto un nuacutemero elevado de pacientes abandonan la medicacioacutenhellipy su inclusioacuten en un programa de Rehabilitacioacuten Cardiacuteaca incrementa la adherencia

CONCEPTO ADHERENCIACONCEPTO ADHERENCIA

bull Proporcioacuten de pacientes que al menos tienen el 75 de los diacuteas cubiertos por los faacutermacos prescritos en un tiempo determinado seguacuten lo recetado

Naderi et al Adherence to drugs that prevent cardiovascular disease meta-nalysis on 376162 patients Am J med 2012125882-7

Problemas de adherencia en prevencioacuten secundaria

Jackevicius CA JAMA 2002

Un 20 de los pacientes croacutenicos no inicia el tratamiento prescrito

Un 50 de pacientes ha abandonado el tratamiento a los 6 meses

McHorney Curr Med Res Opin 2009

El 34 de los pacientes interrumpe el tratamiento de al menos 1 de los faacutermacos y el 12 el de los 3 faacutermacos en el primer mes posterior al alta hospitalaria1

El 24 de los pacientes no cumplen el tratamiento 7 diacuteas despueacutes del alta tras un infarto de miocardio1

7 diacuteas despueacutes

1 de los farmacos

Los 3 farmacos

De las Guiacuteas a la Praacutectica Cliacutenica

ADHERENCIAADHERENCIA

Indicacioacuten de la polipiacuteldoraIndicacioacuten de la polipiacuteldora

bull Prevencioacuten secundaria de accidentes cardiovasculares como tratamiento de sustitucioacuten en pacientes adultos controlados de forma adecuada con los monocomponentes administrados concomitantemente en dosis terapeacuteuticas equivalentes

Conclusiones POLIPILDORAConclusiones POLIPILDORA

bull Con el tratamiento con polipiacuteldora CNIC-FS-Ferrer

aumenta 22 relativo el porcentaje de pacientes

adherentes a la medicacioacuten en pacientes post IAM de

larga evolucioacuten y que teniacutean una baja adherencia basal

bull La polipiacuteldora CNIC-FS-Ferrer es un tratamiento seguro

en estos pacientes tras 9 meses de seguimiento

2 Tratamiento meacutedico ADHERENCIAAm J Med 2009 Oct122(10)961e7-13 doi 101016jamjmed200812021 Epub 2009 Jun 26Long-term medication adherence after myocardial infarction experience of a communityShah ND Dunlay SM Ting HH Montori VM Thomas RJ Wagie AE Roger VLSourceDivision of Health Care Policy and Research Mayo Clinic College of Medicine Rochester MN 55905 USA shahnilaymayoeduAbstractBACKGROUNDAdherence to evidence-based medications after myocardial infarction is associated with improved outcomes However long-term data on factors affecting medication adherence after myocardial infarction are lackingMETHODSOlmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified Adherence to HMG-CoA reductase inhibitors (statins) beta blockers angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were examined Cox proportional hazard regression was used to determine the factors associated with medication adherence over timeRESULTSAmong 292 subjects with incident myocardial infarction (63 men mean age 65 years) patients were followed for an average of 52+-31 months Adherence to guideline-recommended medications decreased over time with 3-year medication continuation rates of 44 48 and 43 for statins beta-blockers and angiotensin-converting enzyme inhibitorsangiotensin II receptor blockers respectively Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications with adjusted hazard ratio (95 confidence interval) for discontinuation of statins and beta-blockers among cardiac rehabilitation participants of 066 (045-092) and 070 (049-098) respectively Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications although results did not reach statistical significance There were no observed associations between demographic characteristics clinical characteristics of the myocardial infarction and medication adherenceCONCLUSIONSAfter myocardial infarction a large proportion of patients discontinue use of medications over time Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherencePMID 19560749 [PubMed - indexed for MEDLINE]

CONCLUSIONES Despueacutes de un infarto un nuacutemero elevado de pacientes abandonan la medicacioacutenhellipy su inclusioacuten en un programa de Rehabilitacioacuten Cardiacuteaca incrementa la adherencia

Problemas de adherencia en prevencioacuten secundaria

Jackevicius CA JAMA 2002

Un 20 de los pacientes croacutenicos no inicia el tratamiento prescrito

Un 50 de pacientes ha abandonado el tratamiento a los 6 meses

McHorney Curr Med Res Opin 2009

El 34 de los pacientes interrumpe el tratamiento de al menos 1 de los faacutermacos y el 12 el de los 3 faacutermacos en el primer mes posterior al alta hospitalaria1

El 24 de los pacientes no cumplen el tratamiento 7 diacuteas despueacutes del alta tras un infarto de miocardio1

7 diacuteas despueacutes

1 de los farmacos

Los 3 farmacos

De las Guiacuteas a la Praacutectica Cliacutenica

ADHERENCIAADHERENCIA

Indicacioacuten de la polipiacuteldoraIndicacioacuten de la polipiacuteldora

bull Prevencioacuten secundaria de accidentes cardiovasculares como tratamiento de sustitucioacuten en pacientes adultos controlados de forma adecuada con los monocomponentes administrados concomitantemente en dosis terapeacuteuticas equivalentes

Conclusiones POLIPILDORAConclusiones POLIPILDORA

bull Con el tratamiento con polipiacuteldora CNIC-FS-Ferrer

aumenta 22 relativo el porcentaje de pacientes

adherentes a la medicacioacuten en pacientes post IAM de

larga evolucioacuten y que teniacutean una baja adherencia basal

bull La polipiacuteldora CNIC-FS-Ferrer es un tratamiento seguro

en estos pacientes tras 9 meses de seguimiento

2 Tratamiento meacutedico ADHERENCIAAm J Med 2009 Oct122(10)961e7-13 doi 101016jamjmed200812021 Epub 2009 Jun 26Long-term medication adherence after myocardial infarction experience of a communityShah ND Dunlay SM Ting HH Montori VM Thomas RJ Wagie AE Roger VLSourceDivision of Health Care Policy and Research Mayo Clinic College of Medicine Rochester MN 55905 USA shahnilaymayoeduAbstractBACKGROUNDAdherence to evidence-based medications after myocardial infarction is associated with improved outcomes However long-term data on factors affecting medication adherence after myocardial infarction are lackingMETHODSOlmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified Adherence to HMG-CoA reductase inhibitors (statins) beta blockers angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were examined Cox proportional hazard regression was used to determine the factors associated with medication adherence over timeRESULTSAmong 292 subjects with incident myocardial infarction (63 men mean age 65 years) patients were followed for an average of 52+-31 months Adherence to guideline-recommended medications decreased over time with 3-year medication continuation rates of 44 48 and 43 for statins beta-blockers and angiotensin-converting enzyme inhibitorsangiotensin II receptor blockers respectively Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications with adjusted hazard ratio (95 confidence interval) for discontinuation of statins and beta-blockers among cardiac rehabilitation participants of 066 (045-092) and 070 (049-098) respectively Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications although results did not reach statistical significance There were no observed associations between demographic characteristics clinical characteristics of the myocardial infarction and medication adherenceCONCLUSIONSAfter myocardial infarction a large proportion of patients discontinue use of medications over time Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherencePMID 19560749 [PubMed - indexed for MEDLINE]

CONCLUSIONES Despueacutes de un infarto un nuacutemero elevado de pacientes abandonan la medicacioacutenhellipy su inclusioacuten en un programa de Rehabilitacioacuten Cardiacuteaca incrementa la adherencia

Jackevicius CA JAMA 2002

Un 20 de los pacientes croacutenicos no inicia el tratamiento prescrito

Un 50 de pacientes ha abandonado el tratamiento a los 6 meses

McHorney Curr Med Res Opin 2009

El 34 de los pacientes interrumpe el tratamiento de al menos 1 de los faacutermacos y el 12 el de los 3 faacutermacos en el primer mes posterior al alta hospitalaria1

El 24 de los pacientes no cumplen el tratamiento 7 diacuteas despueacutes del alta tras un infarto de miocardio1

7 diacuteas despueacutes

1 de los farmacos

Los 3 farmacos

De las Guiacuteas a la Praacutectica Cliacutenica

ADHERENCIAADHERENCIA

Indicacioacuten de la polipiacuteldoraIndicacioacuten de la polipiacuteldora

bull Prevencioacuten secundaria de accidentes cardiovasculares como tratamiento de sustitucioacuten en pacientes adultos controlados de forma adecuada con los monocomponentes administrados concomitantemente en dosis terapeacuteuticas equivalentes

Conclusiones POLIPILDORAConclusiones POLIPILDORA

bull Con el tratamiento con polipiacuteldora CNIC-FS-Ferrer

aumenta 22 relativo el porcentaje de pacientes

adherentes a la medicacioacuten en pacientes post IAM de

larga evolucioacuten y que teniacutean una baja adherencia basal

bull La polipiacuteldora CNIC-FS-Ferrer es un tratamiento seguro

en estos pacientes tras 9 meses de seguimiento

2 Tratamiento meacutedico ADHERENCIAAm J Med 2009 Oct122(10)961e7-13 doi 101016jamjmed200812021 Epub 2009 Jun 26Long-term medication adherence after myocardial infarction experience of a communityShah ND Dunlay SM Ting HH Montori VM Thomas RJ Wagie AE Roger VLSourceDivision of Health Care Policy and Research Mayo Clinic College of Medicine Rochester MN 55905 USA shahnilaymayoeduAbstractBACKGROUNDAdherence to evidence-based medications after myocardial infarction is associated with improved outcomes However long-term data on factors affecting medication adherence after myocardial infarction are lackingMETHODSOlmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified Adherence to HMG-CoA reductase inhibitors (statins) beta blockers angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were examined Cox proportional hazard regression was used to determine the factors associated with medication adherence over timeRESULTSAmong 292 subjects with incident myocardial infarction (63 men mean age 65 years) patients were followed for an average of 52+-31 months Adherence to guideline-recommended medications decreased over time with 3-year medication continuation rates of 44 48 and 43 for statins beta-blockers and angiotensin-converting enzyme inhibitorsangiotensin II receptor blockers respectively Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications with adjusted hazard ratio (95 confidence interval) for discontinuation of statins and beta-blockers among cardiac rehabilitation participants of 066 (045-092) and 070 (049-098) respectively Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications although results did not reach statistical significance There were no observed associations between demographic characteristics clinical characteristics of the myocardial infarction and medication adherenceCONCLUSIONSAfter myocardial infarction a large proportion of patients discontinue use of medications over time Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherencePMID 19560749 [PubMed - indexed for MEDLINE]

CONCLUSIONES Despueacutes de un infarto un nuacutemero elevado de pacientes abandonan la medicacioacutenhellipy su inclusioacuten en un programa de Rehabilitacioacuten Cardiacuteaca incrementa la adherencia

ADHERENCIAADHERENCIA

Indicacioacuten de la polipiacuteldoraIndicacioacuten de la polipiacuteldora

bull Prevencioacuten secundaria de accidentes cardiovasculares como tratamiento de sustitucioacuten en pacientes adultos controlados de forma adecuada con los monocomponentes administrados concomitantemente en dosis terapeacuteuticas equivalentes

Conclusiones POLIPILDORAConclusiones POLIPILDORA

bull Con el tratamiento con polipiacuteldora CNIC-FS-Ferrer

aumenta 22 relativo el porcentaje de pacientes

adherentes a la medicacioacuten en pacientes post IAM de

larga evolucioacuten y que teniacutean una baja adherencia basal

bull La polipiacuteldora CNIC-FS-Ferrer es un tratamiento seguro

en estos pacientes tras 9 meses de seguimiento

2 Tratamiento meacutedico ADHERENCIAAm J Med 2009 Oct122(10)961e7-13 doi 101016jamjmed200812021 Epub 2009 Jun 26Long-term medication adherence after myocardial infarction experience of a communityShah ND Dunlay SM Ting HH Montori VM Thomas RJ Wagie AE Roger VLSourceDivision of Health Care Policy and Research Mayo Clinic College of Medicine Rochester MN 55905 USA shahnilaymayoeduAbstractBACKGROUNDAdherence to evidence-based medications after myocardial infarction is associated with improved outcomes However long-term data on factors affecting medication adherence after myocardial infarction are lackingMETHODSOlmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified Adherence to HMG-CoA reductase inhibitors (statins) beta blockers angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were examined Cox proportional hazard regression was used to determine the factors associated with medication adherence over timeRESULTSAmong 292 subjects with incident myocardial infarction (63 men mean age 65 years) patients were followed for an average of 52+-31 months Adherence to guideline-recommended medications decreased over time with 3-year medication continuation rates of 44 48 and 43 for statins beta-blockers and angiotensin-converting enzyme inhibitorsangiotensin II receptor blockers respectively Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications with adjusted hazard ratio (95 confidence interval) for discontinuation of statins and beta-blockers among cardiac rehabilitation participants of 066 (045-092) and 070 (049-098) respectively Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications although results did not reach statistical significance There were no observed associations between demographic characteristics clinical characteristics of the myocardial infarction and medication adherenceCONCLUSIONSAfter myocardial infarction a large proportion of patients discontinue use of medications over time Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherencePMID 19560749 [PubMed - indexed for MEDLINE]

CONCLUSIONES Despueacutes de un infarto un nuacutemero elevado de pacientes abandonan la medicacioacutenhellipy su inclusioacuten en un programa de Rehabilitacioacuten Cardiacuteaca incrementa la adherencia

Indicacioacuten de la polipiacuteldoraIndicacioacuten de la polipiacuteldora

bull Prevencioacuten secundaria de accidentes cardiovasculares como tratamiento de sustitucioacuten en pacientes adultos controlados de forma adecuada con los monocomponentes administrados concomitantemente en dosis terapeacuteuticas equivalentes

Conclusiones POLIPILDORAConclusiones POLIPILDORA

bull Con el tratamiento con polipiacuteldora CNIC-FS-Ferrer

aumenta 22 relativo el porcentaje de pacientes

adherentes a la medicacioacuten en pacientes post IAM de

larga evolucioacuten y que teniacutean una baja adherencia basal

bull La polipiacuteldora CNIC-FS-Ferrer es un tratamiento seguro

en estos pacientes tras 9 meses de seguimiento

2 Tratamiento meacutedico ADHERENCIAAm J Med 2009 Oct122(10)961e7-13 doi 101016jamjmed200812021 Epub 2009 Jun 26Long-term medication adherence after myocardial infarction experience of a communityShah ND Dunlay SM Ting HH Montori VM Thomas RJ Wagie AE Roger VLSourceDivision of Health Care Policy and Research Mayo Clinic College of Medicine Rochester MN 55905 USA shahnilaymayoeduAbstractBACKGROUNDAdherence to evidence-based medications after myocardial infarction is associated with improved outcomes However long-term data on factors affecting medication adherence after myocardial infarction are lackingMETHODSOlmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified Adherence to HMG-CoA reductase inhibitors (statins) beta blockers angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were examined Cox proportional hazard regression was used to determine the factors associated with medication adherence over timeRESULTSAmong 292 subjects with incident myocardial infarction (63 men mean age 65 years) patients were followed for an average of 52+-31 months Adherence to guideline-recommended medications decreased over time with 3-year medication continuation rates of 44 48 and 43 for statins beta-blockers and angiotensin-converting enzyme inhibitorsangiotensin II receptor blockers respectively Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications with adjusted hazard ratio (95 confidence interval) for discontinuation of statins and beta-blockers among cardiac rehabilitation participants of 066 (045-092) and 070 (049-098) respectively Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications although results did not reach statistical significance There were no observed associations between demographic characteristics clinical characteristics of the myocardial infarction and medication adherenceCONCLUSIONSAfter myocardial infarction a large proportion of patients discontinue use of medications over time Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherencePMID 19560749 [PubMed - indexed for MEDLINE]

CONCLUSIONES Despueacutes de un infarto un nuacutemero elevado de pacientes abandonan la medicacioacutenhellipy su inclusioacuten en un programa de Rehabilitacioacuten Cardiacuteaca incrementa la adherencia

Conclusiones POLIPILDORAConclusiones POLIPILDORA

bull Con el tratamiento con polipiacuteldora CNIC-FS-Ferrer

aumenta 22 relativo el porcentaje de pacientes

adherentes a la medicacioacuten en pacientes post IAM de

larga evolucioacuten y que teniacutean una baja adherencia basal

bull La polipiacuteldora CNIC-FS-Ferrer es un tratamiento seguro

en estos pacientes tras 9 meses de seguimiento

2 Tratamiento meacutedico ADHERENCIAAm J Med 2009 Oct122(10)961e7-13 doi 101016jamjmed200812021 Epub 2009 Jun 26Long-term medication adherence after myocardial infarction experience of a communityShah ND Dunlay SM Ting HH Montori VM Thomas RJ Wagie AE Roger VLSourceDivision of Health Care Policy and Research Mayo Clinic College of Medicine Rochester MN 55905 USA shahnilaymayoeduAbstractBACKGROUNDAdherence to evidence-based medications after myocardial infarction is associated with improved outcomes However long-term data on factors affecting medication adherence after myocardial infarction are lackingMETHODSOlmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified Adherence to HMG-CoA reductase inhibitors (statins) beta blockers angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were examined Cox proportional hazard regression was used to determine the factors associated with medication adherence over timeRESULTSAmong 292 subjects with incident myocardial infarction (63 men mean age 65 years) patients were followed for an average of 52+-31 months Adherence to guideline-recommended medications decreased over time with 3-year medication continuation rates of 44 48 and 43 for statins beta-blockers and angiotensin-converting enzyme inhibitorsangiotensin II receptor blockers respectively Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications with adjusted hazard ratio (95 confidence interval) for discontinuation of statins and beta-blockers among cardiac rehabilitation participants of 066 (045-092) and 070 (049-098) respectively Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications although results did not reach statistical significance There were no observed associations between demographic characteristics clinical characteristics of the myocardial infarction and medication adherenceCONCLUSIONSAfter myocardial infarction a large proportion of patients discontinue use of medications over time Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherencePMID 19560749 [PubMed - indexed for MEDLINE]

CONCLUSIONES Despueacutes de un infarto un nuacutemero elevado de pacientes abandonan la medicacioacutenhellipy su inclusioacuten en un programa de Rehabilitacioacuten Cardiacuteaca incrementa la adherencia

2 Tratamiento meacutedico ADHERENCIAAm J Med 2009 Oct122(10)961e7-13 doi 101016jamjmed200812021 Epub 2009 Jun 26Long-term medication adherence after myocardial infarction experience of a communityShah ND Dunlay SM Ting HH Montori VM Thomas RJ Wagie AE Roger VLSourceDivision of Health Care Policy and Research Mayo Clinic College of Medicine Rochester MN 55905 USA shahnilaymayoeduAbstractBACKGROUNDAdherence to evidence-based medications after myocardial infarction is associated with improved outcomes However long-term data on factors affecting medication adherence after myocardial infarction are lackingMETHODSOlmsted County residents hospitalized with myocardial infarction from 1997-2006 were identified Adherence to HMG-CoA reductase inhibitors (statins) beta blockers angiotensin-converting enzyme inhibitors and angiotensin II receptor blockers were examined Cox proportional hazard regression was used to determine the factors associated with medication adherence over timeRESULTSAmong 292 subjects with incident myocardial infarction (63 men mean age 65 years) patients were followed for an average of 52+-31 months Adherence to guideline-recommended medications decreased over time with 3-year medication continuation rates of 44 48 and 43 for statins beta-blockers and angiotensin-converting enzyme inhibitorsangiotensin II receptor blockers respectively Enrollment in a cardiac rehabilitation program was associated with an improved likelihood of continuing medications with adjusted hazard ratio (95 confidence interval) for discontinuation of statins and beta-blockers among cardiac rehabilitation participants of 066 (045-092) and 070 (049-098) respectively Smoking at the time of myocardial infarction was associated with a decreased likelihood of continuing medications although results did not reach statistical significance There were no observed associations between demographic characteristics clinical characteristics of the myocardial infarction and medication adherenceCONCLUSIONSAfter myocardial infarction a large proportion of patients discontinue use of medications over time Enrollment in cardiac rehabilitation after myocardial infarction is associated with improved medication adherencePMID 19560749 [PubMed - indexed for MEDLINE]

CONCLUSIONES Despueacutes de un infarto un nuacutemero elevado de pacientes abandonan la medicacioacutenhellipy su inclusioacuten en un programa de Rehabilitacioacuten Cardiacuteaca incrementa la adherencia

ACTIVIDAD FIacuteSICAACTIVIDAD FIacuteSICAEUROASPIRE IVEUROASPIRE IV

CAMINO DE SANTIAGO 2015CAMINO DE SANTIAGO 2015

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CAMINO DE SANTIAGO 2015CAMINO DE SANTIAGO 2015

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