<?xml version="1.0" encoding="UTF-8"?><xml><records><record><source-app name="Biblio" version="7.x">Drupal-Biblio</source-app><ref-type>17</ref-type><contributors><authors><author><style face="normal" font="default" size="100%">Choudhry, N. K.</style></author><author><style face="normal" font="default" size="100%">Setoguchi, S.</style></author><author><style face="normal" font="default" size="100%">Levin, R.</style></author><author><style face="normal" font="default" size="100%">Winkelmayer, W. C.</style></author><author><style face="normal" font="default" size="100%">Shrank, W. H.</style></author></authors></contributors><titles><title><style face="normal" font="default" size="100%">Trends in adherence to secondary prevention medications in elderly post-myocardial infarction patients</style></title><secondary-title><style face="normal" font="default" size="100%">Pharmacoepidemiol Drug Saf</style></secondary-title></titles><dates><year><style  face="normal" font="default" size="100%">2008</style></year><pub-dates><date><style  face="normal" font="default" size="100%">Dec</style></date></pub-dates></dates><urls><web-urls><url><style face="normal" font="default" size="100%">http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&amp;db=PubMed&amp;dopt=Citation&amp;list_uids=18956426</style></url></web-urls></urls><number><style face="normal" font="default" size="100%">12</style></number><edition><style face="normal" font="default" size="100%">2008/10/29</style></edition><volume><style face="normal" font="default" size="100%">17</style></volume><pages><style face="normal" font="default" size="100%">1189-96</style></pages><isbn><style face="normal" font="default" size="100%">1099-1557 (Electronic)</style></isbn><language><style face="normal" font="default" size="100%">eng</style></language><abstract><style face="normal" font="default" size="100%">BACKGROUND: Poor levels of medication adherence for patients with coronary heart disease (CHD) have been documented but it is unclear whether adherence has improved over time. METHODS: We assembled a retrospective cohort of lower-income Medicare beneficiaries who were discharged from the hospital after their first acute myocardial infarction (MI) between 1 January 1995 and 31 December 2003. For patients prescribed a statin, ACEI/ARB, beta-blocker, and all 3 of these medications after the hospital discharge, we evaluated medication adherence by determining the proportion of days covered (PDC) for each medication in the subsequent year. RESULTS: Our cohort consisted of a total of 33 646 patients. Adherence rates for statins and beta-blockers, but not ACEI/ARB, increased significantly over time but remained suboptimal. For example, among those patients that received a statin after discharge, 38.6% were fully adherent with therapy in 1995 in contrast to 56.2% in 2003 (p value for trend&lt;0.001). Of patients prescribed all 3 of statin, beta-blocker, and ACEI/ARB, 29.1% and 46.4% were fully adherent in 1995 and 2003, respectively (p value for trend&lt;0.001). CONCLUSIONS: Our analysis demonstrates statistically significant but modest improvements in medication adherence for statins and beta-blockers, but not ACEI/ARBs, among patients discharged from hospital after acute MI. Despite these improvements, rates of non-adherence to these highly effective therapies remain extremely high. Given the health and economic consequences of non-adherence, the development of cost-effective strategies to improve medication adherence should be a clear priority.</style></abstract><accession-num><style face="normal" font="default" size="100%">18956426</style></accession-num><notes><style face="normal" font="default" size="100%">Choudhry, Niteesh KSetoguchi, SokoLevin, RaisaWinkelmayer, Wolfgang CShrank, William HK23 HL090505-02/HL/NHLBI NIH HHS/United StatesEnglandPharmacoepidemiology and drug safetyPharmacoepidemiol Drug Saf. 2008 Dec;17(12):1189-96.</style></notes><auth-address><style face="normal" font="default" size="100%">Division of Pharmacoepidemiology and Pharmacoeconomics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02120, USA. nchoudhry@partners.org</style></auth-address></record></records></xml>