Trial reportJournal of the American College of Cardiology2022
Association of Medication Adherence With Health Outcomes in the ISCHEMIA Trial.
Trial report in Journal of the American College of Cardiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01471522 (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches), which is not on this map. Cited by 19 papers.
What it found
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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.
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.
International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA)
Who cites it
19 citing papers in PubMed, 25 citations in OpenAlex.
- Letter to the editor concerning "Bisphosphonate use is associated with reduced fracture rates in a cohort of patients with Parkinson's disease".Osteoporosis international : a journal established as result of cooperation between the European Foundation for Osteoporosis and the National Osteoporosis Foundation of the USA · 2026Article
- Measuring patient adherence in secondary prevention of atherosclerotic cardiovascular disease: a scoping review.BMJ open · 2026Article
- Clinical Benefits of Invasive Strategy in Stable Angina Patients with Low Systolic Blood Pressure: A Post Hoc Analysis of the ISCHEMIA Trial.Journal of clinical medicine · 2026Article
- Medication Adherence and Antithrombotic Therapy Outcomes: Insights From a Post Hoc Analysis of the AFIRE Trial.JACC. Asia · 2026Article
- The impact of social support on medication adherence among patients with heart failure: health literacy as a mediator.Scientific reports · 2026Article
- Association Between Medication Adherence and Symptom Control in Patients With Chronic Stable Angina.Cureus · 2026Article
- Multilayer perceptron modeling of health literacy and medication adherence determinants in Arab patients with cardiometabolic disease: the role of quality of life, eating behaviors, and physical activity.BMC research notes · 2026Article
- Toward a National Health Digital and Data Architecture: Laying the Foundation for Digital Transformation: Commission on Investment Imperatives for a Healthy Nation.NAM perspectives · 2026Review
- Comparison of Three Adherence Assessment Tools in Omani Patients with Type 2 Diabetes Mellitus: A Single-Center Cross-Sectional Study of Agreement and Association with HbA1c.Patient preference and adherence · 2026Article
- Analysis of Closed Claims in Cardiovascular Medicine: Importance of Nonclinical Factors.JACC. Advances · 2026Article
- Impact of guideline-directed medical therapy on the cardiac or non-cardiac death in acute myocardial infarction.The Korean journal of internal medicine · 2025Article
- Using Early Biomarker Change and Treatment Adherence to Predict Risk of Relapse Among Patients With Chronic Myeloid Leukemia Who Are in Remission.JCO clinical cancer informatics · 2025Article
- Clinical feasibility of a quick response code-based digital self-reporting of medication adherence: results in patients on ticagrelor therapy from the APOLLO-QR observational study.European heart journal. Digital health · 2025Article
- Diagnosing and treating stable angina: a contemporary approach for practicing physicians.Future cardiology · 2025Review
- Article
- Facilitators and Barriers of Incremental Innovation by Fixed Dose Combinations in Cardiovascular Diseases.Journal of cardiovascular development and disease · 2024Article
- Improving medication adherence in cardiovascular disease.Nature reviews. Cardiology · 2024Review
- Article
- Reasons for Nonadherence to the Direct Oral Anticoagulant Apixaban: A Cross-Sectional Survey of Atrial Fibrillation Patients.JACC. Advances · 2023Article
Corrections and comments
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Authors and funding
13 authors at 6 institutions in 1 country.
Funding
Abstract
backgroundThe ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) trial randomized participants with chronic coronary disease (CCD) to guideline-directed medical therapy with or without angiography and revascularization. The study examined the association of nonadherence with health status outcomes.
objectivesThe study sought to compare 12-month health status outcomes of adherent and nonadherent participants with CCD with an a priori hypothesis that nonadherent patients would have better health status if randomized to invasive management.
methodsSelf-reported medication-taking behavior was assessed at randomization with a modified 4-item Morisky-Green-Levine Adherence Scale, and participants were classified as adherent or nonadherent. Twelve-month health status was assessed with the 7-item Seattle Angina Questionnaire (SAQ-7) summary score (SS), which ranges from 0 to 100 (higher score = better). The association of adherence with outcomes was evaluated using Bayesian proportional odds models, including an interaction by study arm (conservative vs invasive).
resultsAmong 4,480 randomized participants, 1,245 (27.8%) were nonadherent at baseline. Nonadherent participants had worse baseline SAQ-7 SS in both conservative (72.9 ± 19.3 vs 75.6 ± 18.4) and invasive (71.0 ± 19.8 vs 74.2 ± 18.7) arms. In adjusted analyses, adherence was associated with higher 12-month SAQ-7 SS in both treatment groups (mean difference in SAQ-7 SS with conservative treatment = 1.6 [95% credible interval: 0.3-2.9] vs with invasive management = 1.9 [95% credible interval: 0.8-3.1]), with no interaction by treatment.
conclusionsMore than 1 in 4 participants reported medication nonadherence, which was associated with worse health status in both conservative and invasive treatment strategies at baseline and 12 months. Strategies to improve medication adherence are needed to improve health status outcomes in CCD, regardless of treatment strategy. (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches [ISCHEMIA]; NCT01471522).
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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.