(Yale School of Medicine/Wikimedia Commons)
3 September 2014. Researchers at Mount Sinai Hospital in New York and National Centre for Cardiovascular Research in Madrid, Spain found a pill combining three cardiovascular drugs usually prescribed separately helps heart attack patients stick to their medications better than the three drugs taken separately. The team led by Valentin Fuster, accredited to both institutions, presented its findings yesterday at the European Society of Cardiology meeting in Barcelona.
Physicians treating people who suffer heart attacks often report problems getting their patients to stick to their prescribed medications, with non-adherence rates at 60 percent or more, which impedes the patients’ recoveries. The authors cite data estimating half of the reduction in cardiovascular deaths in Western countries in the past 20 years can be attributed to heart attack patients taking their medications as prescribed, thus improving medication adherence can lead to fewer subsequent heart attacks.
Fuster and colleagues first surveyed the medication adherence behavior of 2,118 people in Spain, Italy, Argentina, Brazil, and Paraguay who suffered a heart attack to establish baselines and uncover reasons for not taking prescribed medications. Their analysis revealed less than half (46%) of heart attack patients in these countries took their medications, with reasons for non-adherence occurring more among younger patients and those with depression, as well as patients citing problems following a complex regimen, poor health insurance, and a low level of social support.
The team then designed a clinical trial to test a drug containing three medications usually prescribed separately, against the usual practice of prescribing the individual drugs. The trial tested the drug Trinomia, made by Ferrer Laboratories, a Spanish pharmaceutical company, containing:
– 100 milligrams (mg) of aspirin that acts as a blood thinner
– 40 mg of simvastatin, a statin drug to control cholesterol levels
– 10 mg of ramipril, an angiotensin-converting enzyme (ACE) inhibitor to treat high blood pressure
The trial recruited 695 patients from four of the countries in the original analysis — Italy, Argentina, Brazil, and Paraguay — who suffered heart attacks, randomly assigned the patients to receive Trinomia or the three separate drugs, and followed their progress for 9 months. The researchers measured adherence through a standard drug-adherence questionnaire and an audit of the drugs maintained by the patients.
The trial results showed more patients taking the single pill stay with medication schedule (63%) than patients taking three separate medications (52%), with the findings consistent for both the questionnaire and the pill counts. The follow-up also revealed, however, no statistically reliable differences between the single or multiple-drug groups in average blood pressure, cholesterol levels, serious adverse effects, or deaths.
A longer-term trial is in development, says Fuster in a Mount Sinai statement, to test if improved drug adherence with the multi-purpose drug leads to reductions in subsequent heart attacks.
Read more:
- Heart Assn Challenge Seeks Heart Disease Prevention Tools
- Remote Heart Failure Monitoring Device Approved by FDA
- Remote Device Monitoring Linked to Higher Survival Rates
- Injectable Hydrogel Developed to Prevent Heart Attack
- Patch Finds More Heart Rhythm Problems Than Holter Monitor
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