Opportunities to prevent cardiovascular disease lost when patients discontinue medicines
Cardiovascular disease (heart disease, stroke and vascular disease) affects nearly one in five Australians and about 65% of those take medicines for their condition. A new report released today by the Australian Institute of Health and Welfare, Medicines for cardiovascular health: are they used appropriately?, examines how these medicines are being prescribed by GPs and used by patients, and finds some striking disparities.
The report shows steady rises between 2000 and 2006 in the rate of prescriptions for cholesterol lowering agents, blood pressure lowering medicines and clot preventing medicines, which suggests increasing 'best practice' by GPs in managing cardiovascular conditions.
But it also shows that many patients stop taking medicines that are intended to be taken long-term to prevent or treat cardiovascular disease.
Susana Senes, of the Institute's Cardiovascular Disease and Diabetes Unit, said that 10% to 25% of patients had discontinued their medicines six months after starting treatment, and this rose to 21% to 47% 24 months after first being prescribed medication.
This may represent a significant lost opportunity to prevent cardiovascular disease or delay its progression and complications, with medicines known to be effective.
'Cost, side effects, treating conditions with no symptoms, patients' lack of understanding of the condition or benefits of treatment may all be contributing factors,' Ms Senes said.
Use of these medicines was shown to be lower for people in rural areas, who are dispensed these medicines at half the rate of those in cities.
'This rate drops to one-thirtieth or less in remote areas, and this is despite higher deaths from cardiovascular disease in rural and remote areas,' Ms Senes said.
While the report showed disparities in access to cardiovascular medicines, some disparities reflect greater need.
'People with the least socioeconomic advantage were dispensed some cholesterol lowering agents and some clot preventing medicines at a higher rate compared with those with most advantage, which reflects their higher rate of cardiovascular disease,' Ms Senes said.
Adverse effects of cardiovascular and blood medicines were associated with 301 deaths in 2004, and almost 28,500 hospitalisations in 2004-05 (most of these occurring in patients aged 65 years or over).