Evidence map›Paper›PMID 22748400›Full record

SynthesisThe American journal of medicine2012

Adherence to drugs that prevent cardiovascular disease: meta-analysis on 376,162 patients.

Sayed H Naderi, Jonathan P Bestwick, David S Wald

Registry-linked trialOpen access · bronzeAbstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in The American journal of medicine, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05347823 (Study of Adherence to Antihypertensive Drugs and Statins in the Population of Subjects With Hypertension Followed at SIIA Centers, Using an Innovative Monitoring Based on Hair Analysis), which is not on this map. Cited by 366 papers, 19 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
366citing papers in PubMed, 19 pooled it
29.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT05347823 unknown statusnot on this mapstarted 2022, after this paper: background citation

Study of Adherence to Antihypertensive Drugs and Statins in the Population of Subjects With Hypertension Followed at SIIA Centers, Using an Innovative Monitoring Based on Hair Analysis

TypeobservationalSponsorAzienda Ospedaliera Universitaria Integrata VeronaRan2022 to 2023Enrolled200ConditionsArterial Hypertension, Dyslipidemias, Antihypertensive Drugs, StatinsArmsHair analysis for drug concentration
3 · Its place in the literature

Who cites it

366 citing papers in PubMed, 19 syntheses or guidelines pooled it, 849 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. Pooled it
  15. Pooled it
  16. Pooled it
  17. Pooled it
  18. Pooled it
  19. Pooled it
  20. Trial

306 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 1 institution in 1 country.

Sayed H NaderiWolfson Institute of Preventive Medicine, Barts and the London School of Medicine, Queen Mary University of London, Charterhouse Square, UK.
Jonathan P Bestwick
David S Wald
Queen Mary University of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveCombination therapy, specifically with aspirin, cholesterol and blood pressure-lowering drugs, substantially reduces the risk of coronary heart disease, but the full preventive effect is only realized if treatment continues indefinitely. Our objective was to provide a summary estimate of adherence to drugs that prevent coronary heart disease, according to drug class and use in people who have had a myocardial infarction (secondary prevention) and people who have not (primary prevention).

methodsA meta-analysis of data on 376,162 patients from 20 studies assessing adherence using prescription refill frequency for the following 7 drug classes was performed: aspirin, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, calcium-channel blockers, thiazides, and statins. Meta-regression was used to examine the effects of age, payment, and treatment duration.

resultsThe summary estimate for adherence across all studies was 57% (95% confidence interval [CI], 50-64) after a median of 24 months. There were statistically significant differences in adherence between primary and secondary prevention: 50% (CI, 45-56) and 66% (CI, 56-75), respectively (P=.012). Adherence was lower for thiazides (42%) than for angiotensin receptor blockers (61%) in primary prevention (P=.02). There were no other statistically significant differences between any of the drug classes in primary or secondary prevention studies. Adherence decreased by 0.15% points/month (P=.07) and was unrelated to age or whether patients paid for their pills.

conclusionAdherence to preventive treatment is poor and little related to class of drug, suggesting that side effects are not the main cause. General, rather than class-specific, measures at improving adherence are needed.

Indexed as

Drug MonitoringAdrenergic beta-AntagonistsAge FactorsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAnticholesteremic AgentsAntihypertensive AgentsAspirinCalcium Channel BlockersCardiovascular AgentsCardiovascular DiseasesDrug Administration ScheduleDrug CostsDrug PrescriptionsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme InhibitorsAngiotensin Receptor AntagonistsAnticholesteremic AgentsAntihypertensive AgentsAspirinCalcium Channel BlockersCardiovascular AgentsHydroxymethylglutaryl-CoA Reductase InhibitorsPlatelet Aggregation InhibitorsSodium Chloride Symporter Inhibitors

Identifiers

PMID22748400
OpenAlexW2067694868

What OpenQuestion holds

Texttitle and abstract
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.