Medication therapy and treatment goal achievement among persons with coronary heart disease in a general population - Guideline adherence, medication adherence and validation of medication use
Aim - To assess the adherence to medication therapy for secondary prevention and achievement of treatment goals in persons with coronary heart disease (CHD) in a general population. Methods - This project used data from the seventh wave of the Tromsø Study, alone and linked with data from the Norweg...
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UiT The Arctic University of Norway
2021
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ftunivtroemsoe:oai:munin.uit.no:10037/23114 2023-05-15T18:35:00+02:00 Medication therapy and treatment goal achievement among persons with coronary heart disease in a general population - Guideline adherence, medication adherence and validation of medication use Pedersen, Elisabeth 2021-12-13 https://hdl.handle.net/10037/23114 eng eng UiT The Arctic University of Norway UiT Norges arktiske universitet Paper I: Pedersen, E., Garcia, B.H., Halvorsen, K.H., Eggen, A.E., Schirmer, H. & Waaseth, M. (2021). Adherence to prescription guidelines and achievement of treatment goals among persons with coronary heart disease in Tromsø 7. BMC Cardiovascular Disorders, 21 (1), 44. Also available in Munin at https://hdl.handle.net/10037/21735 . Paper II: Pedersen, E., Truong, K.N.L., Garcia, B.H., Halvorsen, K.H., Svendsen, K., Eggen, A.E. & Waaseth, M. Self-reported medication use among coronary heart disease patients showed high validity compared with dispensing data. Journal of Clinical Epidemiology, 135 , 115-124. Also available in Munin at https://hdl.handle.net/10037/21877 . Paper III: Pedersen, E., Primicerio, R., Halvorsen, K.H., Eggen, A.E., Garcia, B.H., Schirmer, H. & Waaseth, M. Medication adherence among persons with coronary heart disease and associations with blood pressure and low-density-lipoprotein-cholesterol. (Submitted manuscript). https://hdl.handle.net/10037/23114 openAccess Copyright 2021 The Author(s) VDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803 VDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803 DOKTOR-003 Doctoral thesis Doktorgradsavhandling 2021 ftunivtroemsoe 2021-11-24T23:54:45Z Aim - To assess the adherence to medication therapy for secondary prevention and achievement of treatment goals in persons with coronary heart disease (CHD) in a general population. Methods - This project used data from the seventh wave of the Tromsø Study, alone and linked with data from the Norwegian Prescription database (NorPD). Participants self-reporting CHD were included (n = 1483). In Paper I, the associations between guideline adherence and achievement of treatment goals were assessed using logistic regression. Paper II validated the self-reported medication use by comparing by it to pharmacy dispensings from NorPD. In Paper III medication adherence was calculated based on pharmacy dispensings from NorPD, and the associations between medication adherence and blood pressure and low-density-lipoprotein (LDL)-cholesterol were explored using linear regressions. Results - Use of lipid-lowering drugs (LLDs) was reported by 76% of the study population, antihypertensive drugs by 72% and acetylsalicylic acid (ASA) by 66%. Agreement between self-reported medication use and pharmacy dispensings was high for all three medication groups (kappa ≥0.61). Average medication adherence (proportion of days covered) was 0.94 for both LLDs and antihypertensive drugs and 0.97 for ASA. The recommended treatment goal for LDL-cholesterol was reached by 9% of the population. Achieving this treatment goal was associated with use of LLDs. Lower LDL-cholesterol was also associated with higher adherence to LLDs. The blood pressure goal was reached by 58% of the population, but achieving this goal was not significantly associated with using antihypertensive drugs. There was also no statistically significant association between adherence to antihypertensive drugs and lower systolic or diastolic blood pressure. Conclusions - Use of and adherence to medications for secondary prevention of CHD was high, but achievement of treatment goals for blood pressure and especially LDL-cholesterol was low. Our results indicate that the lipid-lowering and antihypertensive therapy is not sufficiently intense. The prescription level might be a potential target to improve achievement of treatment goals among persons with CHD and hence prevent new CHD events. Doctoral or Postdoctoral Thesis Tromsø University of Tromsø: Munin Open Research Archive Tromsø |
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University of Tromsø: Munin Open Research Archive |
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ftunivtroemsoe |
language |
English |
topic |
VDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803 VDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803 DOKTOR-003 |
spellingShingle |
VDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803 VDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803 DOKTOR-003 Pedersen, Elisabeth Medication therapy and treatment goal achievement among persons with coronary heart disease in a general population - Guideline adherence, medication adherence and validation of medication use |
topic_facet |
VDP::Medisinske Fag: 700::Helsefag: 800::Epidemiologi medisinsk og odontologisk statistikk: 803 VDP::Medical disciplines: 700::Health sciences: 800::Epidemiology medical and dental statistics: 803 DOKTOR-003 |
description |
Aim - To assess the adherence to medication therapy for secondary prevention and achievement of treatment goals in persons with coronary heart disease (CHD) in a general population. Methods - This project used data from the seventh wave of the Tromsø Study, alone and linked with data from the Norwegian Prescription database (NorPD). Participants self-reporting CHD were included (n = 1483). In Paper I, the associations between guideline adherence and achievement of treatment goals were assessed using logistic regression. Paper II validated the self-reported medication use by comparing by it to pharmacy dispensings from NorPD. In Paper III medication adherence was calculated based on pharmacy dispensings from NorPD, and the associations between medication adherence and blood pressure and low-density-lipoprotein (LDL)-cholesterol were explored using linear regressions. Results - Use of lipid-lowering drugs (LLDs) was reported by 76% of the study population, antihypertensive drugs by 72% and acetylsalicylic acid (ASA) by 66%. Agreement between self-reported medication use and pharmacy dispensings was high for all three medication groups (kappa ≥0.61). Average medication adherence (proportion of days covered) was 0.94 for both LLDs and antihypertensive drugs and 0.97 for ASA. The recommended treatment goal for LDL-cholesterol was reached by 9% of the population. Achieving this treatment goal was associated with use of LLDs. Lower LDL-cholesterol was also associated with higher adherence to LLDs. The blood pressure goal was reached by 58% of the population, but achieving this goal was not significantly associated with using antihypertensive drugs. There was also no statistically significant association between adherence to antihypertensive drugs and lower systolic or diastolic blood pressure. Conclusions - Use of and adherence to medications for secondary prevention of CHD was high, but achievement of treatment goals for blood pressure and especially LDL-cholesterol was low. Our results indicate that the lipid-lowering and antihypertensive therapy is not sufficiently intense. The prescription level might be a potential target to improve achievement of treatment goals among persons with CHD and hence prevent new CHD events. |
format |
Doctoral or Postdoctoral Thesis |
author |
Pedersen, Elisabeth |
author_facet |
Pedersen, Elisabeth |
author_sort |
Pedersen, Elisabeth |
title |
Medication therapy and treatment goal achievement among persons with coronary heart disease in a general population - Guideline adherence, medication adherence and validation of medication use |
title_short |
Medication therapy and treatment goal achievement among persons with coronary heart disease in a general population - Guideline adherence, medication adherence and validation of medication use |
title_full |
Medication therapy and treatment goal achievement among persons with coronary heart disease in a general population - Guideline adherence, medication adherence and validation of medication use |
title_fullStr |
Medication therapy and treatment goal achievement among persons with coronary heart disease in a general population - Guideline adherence, medication adherence and validation of medication use |
title_full_unstemmed |
Medication therapy and treatment goal achievement among persons with coronary heart disease in a general population - Guideline adherence, medication adherence and validation of medication use |
title_sort |
medication therapy and treatment goal achievement among persons with coronary heart disease in a general population - guideline adherence, medication adherence and validation of medication use |
publisher |
UiT The Arctic University of Norway |
publishDate |
2021 |
url |
https://hdl.handle.net/10037/23114 |
geographic |
Tromsø |
geographic_facet |
Tromsø |
genre |
Tromsø |
genre_facet |
Tromsø |
op_relation |
Paper I: Pedersen, E., Garcia, B.H., Halvorsen, K.H., Eggen, A.E., Schirmer, H. & Waaseth, M. (2021). Adherence to prescription guidelines and achievement of treatment goals among persons with coronary heart disease in Tromsø 7. BMC Cardiovascular Disorders, 21 (1), 44. Also available in Munin at https://hdl.handle.net/10037/21735 . Paper II: Pedersen, E., Truong, K.N.L., Garcia, B.H., Halvorsen, K.H., Svendsen, K., Eggen, A.E. & Waaseth, M. Self-reported medication use among coronary heart disease patients showed high validity compared with dispensing data. Journal of Clinical Epidemiology, 135 , 115-124. Also available in Munin at https://hdl.handle.net/10037/21877 . Paper III: Pedersen, E., Primicerio, R., Halvorsen, K.H., Eggen, A.E., Garcia, B.H., Schirmer, H. & Waaseth, M. Medication adherence among persons with coronary heart disease and associations with blood pressure and low-density-lipoprotein-cholesterol. (Submitted manuscript). https://hdl.handle.net/10037/23114 |
op_rights |
openAccess Copyright 2021 The Author(s) |
_version_ |
1766220048536436736 |