Success Stories:
Atherothrombotic Events


Improving adherence to dual antiplatelet therapy in France


Background

  • 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

The need for effective treatment and prevention of thromboembolic events is clear:
  • 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 was emphasised (Wallentin L et al (2009) N Engl J Med 361(11): 1045-57)

  • Our challenge was to encourage adherence to twice-daily 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 We Helped

Patient Connect's clinical team understood the adherence challenges of dual antiplatelet therapy at a country level and developed evidence-based clinical messages based on these

Pharmacists across our French network of 9,800 pharmacies were alerted to the adherence challenge

The pharmacist verbalised the evidence-based clinical messages to patients at the point of dispensing the target medication




Results

  • Average medication possession ratio (MPR) in new patients increased from month two of the support programme, and increased steadily throughout the programme

  • By month four, average MPR was twice that of month two, suggesting the support programme had a significant impact on compliance

Relative increase in average medication possession ratio
(MPR) in new patients

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Diabetes

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