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Drug Adherence with Cardiovascular Medicines: Statins and Aspirin

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Drug Adherence in Hypertension and Cardiovascular Protection

Part of the book series: Updates in Hypertension and Cardiovascular Protection ((UHCP))

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Abstract

Statins and aspirin are both widely used low-cost therapies, with known adverse effect profiles, that are prescribed to treat a symptomless condition or to prevent future adverse cardiovascular events. Despite their proven efficacy in the prevention of cardiovascular morbidity and mortality, non-adherence to these medicines is prevalent. Reported rates of non-adherence vary substantially across studies; based on meta-analyses, only every second patient who initiates statin therapy adheres to it, and non-adherence is more common in primary than in secondary prevention. Adherence to aspirin is somewhat better, being comparable to statin adherence in secondary prevention (~70%). However, these rates underestimate non-adherence by missing those who do not initiate medicine use (primary non-adherence). Use of these cardioprotective medicines is a dynamic process where adherence can change over time and many patients who discontinue medicine use reinitiate it. The most important patient-reported reason for non-adherence is adverse effects. Recently, negative media coverage has been implicated as a reason for discontinuation of statin therapy. The multitude of risk factors for non-adherence, in addition to complexity of adherence behavior, is likely to complicate efforts to improve adherence to statins and aspirin.

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Authors and Affiliations

  1. Institute of Biomedicine, University of Turku, Turku, Finland

    Maarit Jaana Korhonen Ph.D. & Emma Aarnio Ph.D.

  2. Faculty of Pharmacy and Pharmaceutical Sciences, Centre for Medicine Use and Safety, Monash University, Melbourne, VIC, Australia

    Maarit Jaana Korhonen Ph.D.

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  1. Maarit Jaana Korhonen Ph.D.
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  2. Emma Aarnio Ph.D.
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Correspondence to Maarit Jaana Korhonen Ph.D. .

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  1. Service of Nephrology and Hypertension, CHUV, University of Lausanne, Lausanne, Vaud, Switzerland

    Michel Burnier

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Korhonen, M.J., Aarnio, E. (2018). Drug Adherence with Cardiovascular Medicines: Statins and Aspirin. In: Burnier, M. (eds) Drug Adherence in Hypertension and Cardiovascular Protection. Updates in Hypertension and Cardiovascular Protection. Springer, Cham. https://doi.org/10.1007/978-3-319-76593-8_15

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