Decreasing Heart Disease Hospitalizations

May 14, 2012
Patients over 65 who did not take their medicines as prescribed had a 30% higher risk of cardiovascular-related hospitalization when compared to adherent patients.
  • Accountable Care Organization (ACO)
  • High Blood Pressure/Heart Disease

Heart disease kills nearly 600,000 Americans annually and leads to 16.7 million visits to hospitals, emergency departments and doctors. Exercise and eating right could prevent many of these deaths and trips to the hospital, but for the 11.8% of Americans diagnosed with heart disease, medication is the key ingredient in keeping these patients healthy. This is particularly so for older persons managing a cardiovascular condition.

According to research we released today (Statin Nonadherence and Antihypertensive Nonadherence), older patients with high cholesterol or high blood pressure, have a greater risk for unnecessary hospitalizations if they don’t follow their doctors’ orders about taking their medications.

Data from the two studies – presented at the American Heart Association’s Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke 2012 Scientific Sessions in Atlanta – show that patients 65 and older who did not take their medicines as prescribed had around a 30% higher risk of a cardiovascular-related hospitalization when compared to patients who took their medications as prescribed.

In addition, one of the studies revealed that nonadherent high blood pressure patients on a Medicare Part D plan have a particularly high risk for cardiovascular-related hospitalizations (42% greater risk) and emergency room visits (29% greater risk).

High cholesterol and other cardiovascular diseases such as high blood pressure, heart failure and heart attack are more prevalent among the 65 and older population. These conditions can be well-managed with affordable prescription medications.

However, conditions like high cholesterol and high blood pressure are usually asymptomatic, so patients often forget how important it is to take these medicines. The failure to remain on treatment can increase the risk of heart attack, stroke or cardiovascular-related death.

Considering the high prevalence of cardiovascular conditions among seniors, medication nonadherence can have significant economic implications. Past data suggest, on average, 1/3 to 1/2 of all patients do not comply with prescribed treatment regimens. In the two new studies, 1-in-4 of the study subjects were nonadherent to statins (for high cholesterol), and 1-in-7 members were not adherent to their hypertension medications.

Policymakers who are trying to manage Medicare costs should take note: healthcare costs drop when the system – including pharmacists as providers of clinical care – focuses on adherence to essential medications. Many costly and potentially life-threatening hospitalizations can be avoided.

Tools, like Express Scripts’ recently launched ScreenRx (SM) program, can help payors better address the issue of medication nonadherence. Leveraging the power of predictive modeling, ScreenRx understands the behaviors that drive nonadherence, identifies patients at risk for those behaviors and tailors interventions to help keep patients on their medication therapies.

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