Improving Medication Adherence in Cardiometabolic Disease: Practical and Regulatory Implications

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• 作者：Keith C. Ferdinand ; MD^a ; ^{kcferdmd@aol.com} ; Fortunato Fred Senatore ; MD ; PhD^b ; Helene Clayton-Jeter ; OD^b ; Dennis R. Cryer ; MD^c ; John C. Lewin ; MD^d ; Samar A. Nasser ; PhD ; MPH ; PA-C^e ; Mona Fiuzat ; PharmD^b ; Robert M. Califf ; MD^b
• 关键词：cardiovascular disease ; nonadherence ; polypill ; United States Food and Drug Administration
• 刊名：Journal of the American College of Cardiology
• 出版年：2017
• 出版时间：31 January 2017
• 年：2017
• 卷：69
• 期：4
• 页码：437-451
• 全文大小：484 K
• 卷排序：69

文摘

Medication nonadherence, a major problem in cardiovascular disease (CVD), contributes yearly to approximately 125,000 preventable deaths, which is partly attributable to only about one-half of CVD patients consistently taking prescribed life-saving medications. Current interest has focused on how labeling and education influence adherence. This paper summarizes the scope of CVD nonadherence, describes key U.S. Food and Drug Administration initiatives, and identifies potential targets for improvement. We describe key adherence factors, methods, and technological applications for simplifying regimens and enhancing adherence, and 4 areas where additional collaborative research and implementation involving the regulatory system and clinical community could substantially reduce nonadherence: 1) identifying monitoring methods; 2) improving the evidence base to better understand adherence; 3) developing patient/health provider team-based engagement strategies; and 4) alleviating health disparities. Alignment of U.S. Food and Drug Administration approaches to dissemination of information about appropriate use with clinical practice could improve adherence, and thereby reduce CVD death and disability.