Some Heart Attack Patients Are Skipping Medications

Cardiovascular medications were not taken by heart attack patients who believed the medications made no difference

/ Author:  / Reviewed by: Joseph V. Madia, MD Beth Bolt, RPh

(RxWiki News) People with a history of heart attack are at risk of having another. Though medications are often prescribed to stave off another heart attack, not all patients follow that prescription.

In a new study, patients who either assumed that medication would not help or that they did not need the medications stopped taking them.

According to the researchers, more needs to be done to guard against patient refusals to take their medications, which have been credited with significantly curbing additional heart attacks in recent years. Such medications are designed, for example, to lower unhealthy levels of cholesterol.

"Ask your doctor about maintaining a healthy heart."

Mohammed A. Rashid, MSc, of the University of Cambridge in Cambridge, United Kingdom, was lead author of this study.

Rashid and colleagues analyzed 17 previous studies with a total of 391 heart attack patients and their spouses or partners. These researchers were aiming to determine how patient beliefs and understanding about their own disease and their doctor’s approach to follow-up care affected patients' decisions to take their prescribed medications.

The 17 studies had been conducted in Australia, China, parts of Europe, the United States and United Kingdom between January 1990 and March 2012.

Along with changes in diet and exercise routines, special medications have helped curb the number of fatal cardiovascular events occurring after a person’s initial heart attack, the researchers wrote. Those medications include ones to prevent blood clots, lower cholesterol and blood pressure, regulate heart rhythm, and stop heart pain (angina).

Nevertheless, several factors have contributed to the failure of some patients to follow medication-taking instructions. Those factors include patient beliefs that the medications either would not help or that they didn’t need them. Those who wrongly concluded that they didn’t need the medications based that reasoning partly on the fact that they felt fine after discontinuing their medications for a few days.

Also, patients who were not taking their medicine did not always take seriously the link between everyday habits that can worsen heart disease, the researchers wrote. Those patients sometimes assumed the heart attack was a one-time event, not an ongoing condition that would require their and their physicians’ care and attention.

In some cases, doctors have not taken the time to respectfully explain to patients the details of their heart conditions or persuade their patients that their hearts must be medically monitored for the rest of their lives.

Based on patient responses noted in the studies, these patients generally held their doctors in high regard. Because of that, the approach physicians take as they lay out instructions for patients' ongoing, prescribed care and lifestyle changes also is important.

Doctors must provide “an accessible route for patients to discuss medication concerns and giving out balanced information about recurrent disease risk, including the association between individual risk factors and coronary heart disease,” the researchers wrote.

These researchers continued: “Providing medication-specific information at the time of initiating therapy, improving the transition between secondary and primary care, and explaining the risk of disease recurrence may help to modify patient attitudes toward drugs to prevent further cardiovascular disease.”

This study was published online May 12 in Annals of Family Medicine.

The National Institute for Heart Research in the United Kingdom funded this study.

Study authors reported that they had no financial investments or other ethical conflicts of interest that would shape study design, outcomes or analysis.

Review Date: 
May 12, 2014
Last Updated:
May 13, 2014