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Predictors of Low Clopidogrel Adherence Following Percutaneous Coronary Intervention

Few data are available on factors associated with low adherence or early clopidogrel discontinuation after percutaneous coronary intervention (PCI). Patients (n = 284) were evaluated before hospital discharge after PCI to identify factors associated with low adherence to clopidogrel 30 days later. A... Full description

Journal Title: The American journal of cardiology 2011, Vol.108 (6), p.822-827
Main Author: Muntner, Paul, PhD
Other Authors: Mann, Devin M., MD , Woodward, Mark, PhD , Choi, James W., MD , Stoler, Robert C., MD , Shimbo, Daichi, MD , Farkouh, Michael E., MD , Kim, Michael C., MD
Format: Electronic Article Electronic Article
Language: English
Subjects:
Publisher: New York, NY: Elsevier Inc
ID: ISSN: 0002-9149
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title: Predictors of Low Clopidogrel Adherence Following Percutaneous Coronary Intervention
format: Article
creator:
  • Muntner, Paul, PhD
  • Mann, Devin M., MD
  • Woodward, Mark, PhD
  • Choi, James W., MD
  • Stoler, Robert C., MD
  • Shimbo, Daichi, MD
  • Farkouh, Michael E., MD
  • Kim, Michael C., MD
subjects:
  • Abridged Index Medicus
  • Angioplasty
  • Angioplasty, Balloon, Coronary
  • Article
  • Biological and medical sciences
  • Cardiology
  • Cardiology. Vascular system
  • Cardiovascular
  • cardiovascular diseases
  • Clopidgrel
  • Coronary Disease - drug therapy
  • Coronary Disease - therapy
  • Diseases of the cardiovascular system
  • Drug dosages
  • Female
  • Humans
  • Male
  • Medical sciences
  • Medication Adherence
  • Middle Aged
  • New York
  • operative
  • Patient compliance
  • percutaneous coronary intervention
  • Platelet Aggregation Inhibitors - administration & dosage
  • Predictive Value of Tests
  • Prescription drugs
  • Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
  • Risk Factors
  • surgical procedures
  • Surveys and Questionnaires
  • Texas
  • Ticlopidine - administration & dosage
  • Ticlopidine - analogs & derivatives
  • Treatment Outcome
ispartof: The American journal of cardiology, 2011, Vol.108 (6), p.822-827
description: Few data are available on factors associated with low adherence or early clopidogrel discontinuation after percutaneous coronary intervention (PCI). Patients (n = 284) were evaluated before hospital discharge after PCI to identify factors associated with low adherence to clopidogrel 30 days later. Adherence to daily medications before PCI was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) and categorized as low (score
language: eng
source:
identifier: ISSN: 0002-9149
fulltext: no_fulltext
issn:
  • 0002-9149
  • 1879-1913
url: Link


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titlePredictors of Low Clopidogrel Adherence Following Percutaneous Coronary Intervention
creatorMuntner, Paul, PhD ; Mann, Devin M., MD ; Woodward, Mark, PhD ; Choi, James W., MD ; Stoler, Robert C., MD ; Shimbo, Daichi, MD ; Farkouh, Michael E., MD ; Kim, Michael C., MD
creatorcontribMuntner, Paul, PhD ; Mann, Devin M., MD ; Woodward, Mark, PhD ; Choi, James W., MD ; Stoler, Robert C., MD ; Shimbo, Daichi, MD ; Farkouh, Michael E., MD ; Kim, Michael C., MD
descriptionFew data are available on factors associated with low adherence or early clopidogrel discontinuation after percutaneous coronary intervention (PCI). Patients (n = 284) were evaluated before hospital discharge after PCI to identify factors associated with low adherence to clopidogrel 30 days later. Adherence to daily medications before PCI was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) and categorized as low (score <6), medium (score 6 to <8), or high (score 8). Low adherence to clopidogrel was defined as MMAS-8 score <6 (n = 21) or having discontinued clopidogrel (n = 11), which was ascertained during a 30-day interview after PCI. At 30 days after PCI, 11% of patients had low adherence to clopidogrel. Odds ratios (95% confidence intervals [CIs]) for low adherence to clopidogrel were 3.78 (1.09 to 13.1), 3.06 (1.36 to 6.87), 2.46 (0.97 to 6.27), and 3.36 (0.99 to 11.4) for patients who before PCI reported taking smaller doses of medication because of cost, had difficulty filling prescriptions, had difficulty reaching their primary physician, and were not comfortable asking their doctor for instructions, respectively. Odds ratios (95% CIs) for low clopidogrel adherence after PCI in patients with medium and low versus high adherence to daily medications before PCI were 6.13 (1.34 to 28.2) and 10.9 (2.46 to 48.7), respectively. The c-statistic associated with MMAS-8 scores before PCI for discriminating low clopidogrel adherence at 30 days after PCI was 0.733 (95% CI 0.650 to 0.852). In conclusion, adherence to daily medications before PCI may be a useful indicator for identifying patients who will have low clopidogrel adherence after PCI.
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subjectAbridged Index Medicus ; Angioplasty ; Angioplasty, Balloon, Coronary ; Article ; Biological and medical sciences ; Cardiology ; Cardiology. Vascular system ; Cardiovascular ; cardiovascular diseases ; Clopidgrel ; Coronary Disease - drug therapy ; Coronary Disease - therapy ; Diseases of the cardiovascular system ; Drug dosages ; Female ; Humans ; Male ; Medical sciences ; Medication Adherence ; Middle Aged ; New York ; operative ; Patient compliance ; percutaneous coronary intervention ; Platelet Aggregation Inhibitors - administration & dosage ; Predictive Value of Tests ; Prescription drugs ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Risk Factors ; surgical procedures ; Surveys and Questionnaires ; Texas ; Ticlopidine - administration & dosage ; Ticlopidine - analogs & derivatives ; Treatment Outcome
ispartofThe American journal of cardiology, 2011, Vol.108 (6), p.822-827
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1Mann, Devin M., MD
2Woodward, Mark, PhD
3Choi, James W., MD
4Stoler, Robert C., MD
5Shimbo, Daichi, MD
6Farkouh, Michael E., MD
7Kim, Michael C., MD
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0Predictors of Low Clopidogrel Adherence Following Percutaneous Coronary Intervention
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descriptionFew data are available on factors associated with low adherence or early clopidogrel discontinuation after percutaneous coronary intervention (PCI). Patients (n = 284) were evaluated before hospital discharge after PCI to identify factors associated with low adherence to clopidogrel 30 days later. Adherence to daily medications before PCI was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) and categorized as low (score <6), medium (score 6 to <8), or high (score 8). Low adherence to clopidogrel was defined as MMAS-8 score <6 (n = 21) or having discontinued clopidogrel (n = 11), which was ascertained during a 30-day interview after PCI. At 30 days after PCI, 11% of patients had low adherence to clopidogrel. Odds ratios (95% confidence intervals [CIs]) for low adherence to clopidogrel were 3.78 (1.09 to 13.1), 3.06 (1.36 to 6.87), 2.46 (0.97 to 6.27), and 3.36 (0.99 to 11.4) for patients who before PCI reported taking smaller doses of medication because of cost, had difficulty filling prescriptions, had difficulty reaching their primary physician, and were not comfortable asking their doctor for instructions, respectively. Odds ratios (95% CIs) for low clopidogrel adherence after PCI in patients with medium and low versus high adherence to daily medications before PCI were 6.13 (1.34 to 28.2) and 10.9 (2.46 to 48.7), respectively. The c-statistic associated with MMAS-8 scores before PCI for discriminating low clopidogrel adherence at 30 days after PCI was 0.733 (95% CI 0.650 to 0.852). In conclusion, adherence to daily medications before PCI may be a useful indicator for identifying patients who will have low clopidogrel adherence after PCI.
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1Angioplasty
2Angioplasty, Balloon, Coronary
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25Predictive Value of Tests
26Prescription drugs
27Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
28Risk Factors
29surgical procedures
30Surveys and Questionnaires
31Texas
32Ticlopidine - administration & dosage
33Ticlopidine - analogs & derivatives
34Treatment Outcome
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titlePredictors of Low Clopidogrel Adherence Following Percutaneous Coronary Intervention
authorMuntner, Paul, PhD ; Mann, Devin M., MD ; Woodward, Mark, PhD ; Choi, James W., MD ; Stoler, Robert C., MD ; Shimbo, Daichi, MD ; Farkouh, Michael E., MD ; Kim, Michael C., MD
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abstractFew data are available on factors associated with low adherence or early clopidogrel discontinuation after percutaneous coronary intervention (PCI). Patients (n = 284) were evaluated before hospital discharge after PCI to identify factors associated with low adherence to clopidogrel 30 days later. Adherence to daily medications before PCI was assessed using the 8-item Morisky Medication Adherence Scale (MMAS-8) and categorized as low (score <6), medium (score 6 to <8), or high (score 8). Low adherence to clopidogrel was defined as MMAS-8 score <6 (n = 21) or having discontinued clopidogrel (n = 11), which was ascertained during a 30-day interview after PCI. At 30 days after PCI, 11% of patients had low adherence to clopidogrel. Odds ratios (95% confidence intervals [CIs]) for low adherence to clopidogrel were 3.78 (1.09 to 13.1), 3.06 (1.36 to 6.87), 2.46 (0.97 to 6.27), and 3.36 (0.99 to 11.4) for patients who before PCI reported taking smaller doses of medication because of cost, had difficulty filling prescriptions, had difficulty reaching their primary physician, and were not comfortable asking their doctor for instructions, respectively. Odds ratios (95% CIs) for low clopidogrel adherence after PCI in patients with medium and low versus high adherence to daily medications before PCI were 6.13 (1.34 to 28.2) and 10.9 (2.46 to 48.7), respectively. The c-statistic associated with MMAS-8 scores before PCI for discriminating low clopidogrel adherence at 30 days after PCI was 0.733 (95% CI 0.650 to 0.852). In conclusion, adherence to daily medications before PCI may be a useful indicator for identifying patients who will have low clopidogrel adherence after PCI.
copNew York, NY
pubElsevier Inc
pmid21741610
doi10.1016/j.amjcard.2011.04.034
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