Prevention of atherothrombotic events

Improving adherence to dual antiplatelet therapy in France

Dual antiplatelet therapy is critical in preventing recurrent ischaemic events in patients with acute coronary syndrome, and in preventing early stent thrombosis after percutaneous coronary intervention
Patients who prematurely discontinue their antiplatelet therapy have an increased risk of myocardial infarction and cardiovascular death due to their underlying disease

The challenge

  • Non-adherence to antiplatelet therapy is a risk factor for cardiovascular disease
  • In one study, 23.4% of patients discontinued dual antiplatelet therapy prematurely, even in a study setting where importance of adherence is emphasised (Wallentin L et al (2009) N Engl J Med 361(11): 1045-57)
  • Our challenge was to encourage adherence to twice daily of a medication in patients who often remain asymptomatic from a cardiovascular point of view
  • This challenge increases when these patients experience treatment side effects, such as dyspnoea

How Patient Connect helped

Patient Connect’s clinical team developed messages addressing specific issues of adherence for patients taking antiplatelet medication

Patient Connect’s network of 9,800 community pharmacies across France were alerted to the challenge

Pharmacists verbalised the clinical messages to patients at the point-of-dispensing the target antiplatelet medication

"Remember to take your medication 12 hours apart: twice a day, every day"

Results

  • Average medication possession ratio (MPR) in new patients increased from month two of the support programme, and increased steadily throughout the program
  • By month four, average MPR was twice that of month two, suggesting the support programme had a significant impact on compliance
MPR = A measure of patient adherence. Determines the percentage of days a patient was in possession of their medication.