Half of heart stent patients don’t follow oral antiplatelet therapy regime as prescribed

A recent survey conducted by Harris Poll found that 52% of 275 acute coronary syndrome (ACS) patients who were currently taking an oral antiplatelet have missed taking or changed the way they take their prescribed oral antiplatelet therapy, even though most of them were informed by their doctors of the importance of the therapy to their heart health.

Of these respondents, those under age 65 (194 participants) were much more likely not to follow their oral antiplatelet therapy regimen as prescribed than older respondents, even though they were more concerned about their health, according to the survey findings. People with ACS who undergo an angioplasty procedure and receive a heart stent are prescribed an oral antiplatelet therapy and aspirin to help prevent a heart attack, a blood clot in their heart stent (stent thrombosis), or even death.

12% of survey respondents did not recall being informed about the serious health risks associated with not adhering to their oral antiplatelet therapy

To address this critical issue, the Preventive Cardiovascular Nurses Association (PCNA), Society for Cardiovascular Angiography and Interventions (SCAI) and Mended Hearts, with support from Daiichi Sankyo and Eli Lilly and Company, urge health care professionals to increase their efforts to help ACS patients stick to their prescribed oral antiplatelet therapy following an angioplasty or cardiac stent procedure. As the survey found: 12% of the total survey respondents said they do not recall being informed by their health care professionals that they faced serious health risks if they did not adhere to their oral antiplatelet therapy.

“For people who have recently received a heart stent for ACS, changing, skipping or discontinuing oral antiplatelet therapy increases the risk of serious heart problems or even death,” said Jeffrey Cavendish MD, FSCAI, FACC, lead interventional cardiologist for Kaiser Permanente San Diego and director of the cardiac catheterization laboratory at the Scripps Prebys Cardiovascular Institute in La Jolla, California.

To help ACS patients prevent recurrent heart events after an angioplasty procedure, SCAI, PCNA and Mended Hearts are introducing the “After the Stent: Follow Your Action PlanTM” campaign. The campaign aims to mobilize cardiovascular health care professionals to improve ACS patients’ knowledge and practices related to oral antiplatelet adherence.

16% of ACS patients stop taking their prescribed oral antiplatelet therapy in the first 30 days

Annually, about 610,000 people with ACS, which includes heart attack and a type of chest pain called unstable angina (UA), undergo an angioplasty procedure to open a blocked coronary artery. Clinical research shows that up to 16% of these patients stop taking their prescribed oral antiplatelet therapy in the first 30 days, which leaves them more vulnerable to another heart event and increases by 10-fold their risk of death at one year.

“Patients may stop taking their oral antiplatelet medication for a variety of reasons, such as mistakenly believing their heart condition is ‘fixed’ or not understanding why or how long they need to take the medication,” said Lola Coke, PHD, ACNS-BC, RN-BC, FAHA, FPCNA, associate professor of nursing and cardiovascular clinical nurse specialist at Rush University Medical Center in Chicago, Illinois, and member of the board of directors of PCNA. “Identifying and correcting these misunderstandings is a first step health care professionals can take to ensure medication adherence. Health care professionals need to make sure that ACS patients and caregivers have the right information and support to follow their medication regimens.”

To launch the “After the Stent: Follow Your Action PlanTM” campaign, PCNA and SCAI published a position paper that demonstrates the need for increased attention to oral antiplatelet medication and highlights practical, research-based solutions to address non-adherence through education, mobilization, personalisation and teamwork.

Additionally, the groups have developed an oral antiplatelet non-adherence risk Assessment for health care professionals to use with their patients. The Assessment includes the 8-question Morisky Medication Adherence Screener, widely used in other disease categories to assess medication adherence, six questions specific to ACS patients who have undergone an angioplasty procedure, and a Conversation Guide to help health care professionals tailor conversations with individual patients based on the risk factors identified in the Assessment questionnaires.

The survey also found that of the 296 respondents who visited a health care professional within the 12 months following their angioplasty procedure, 20% said they had questions about their prescribed oral antiplatelet medication that were not addressed by their health care team.

“Coping with a heart event is an overwhelming experience for patients and their families, which makes it especially important that health care professionals take the time to explain what occurred and what needs to happen after the angioplasty procedure to help prevent another heart event,” said Donnette Smith, executive vice president of Mended Hearts. “It is also equally important that patients and caregivers ask their health care team questions if they have concerns or are not clear why or how they should follow their new medication regimen. There are excellent support programs and tools available to help patients to successfully manage their oral antiplatelet medication routine. We encourage ACS patients and caregivers to ask for help and support resources.”