Adherence to dual antiplatelet therapy: can we do better?

Abstract

Management strategies to ensure medication adherence for patients following percutaneous coronary intervention have not changed in recent years despite the dismal rates of non-compliance with dual antiplatelet therapy. The goal of this review is to emphasis the importance of dual antiplatelet therapy in patients following percutaneous coronary intervention, discuss the clinical and economic ramifications of premature discontinuation and strategies for improvement.

Keywords::

• adherence
• antiplatelet
• dual antiplatelet therapy

Financial & competing interests disclosure

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

No writing assistance was utilized in the production of this manuscript.

Key issues

• • Compliance with dual antiplatelet therapy (DAPT) in post-percutaneous coronary intervention (post-PCI) patients is a serious global concern because of its potential to impact patient outcomes.

• • There are multiple patient-related variables associated with non-adherence to DAPT such as in access to care, socioeconomic and financial barriers, lack of patient understanding and other comorbid conditions.

• • Given the prevalence of non-adherence to DAPT in the post-PCI patient, strategies targeting these issues can potentially have a dramatic impact on cardiac outcomes including survival.

• • In the future, a deeper understanding of patient-specific characteristics, along with newer generation antiplatelet agents and stent design may pave the way for improved patient selection and better rates of compliance.

• • Further investigation is needed to establish which methods for improving compliance are indeed efficacious and can confer tangible benefits for post-PCI patients.

Notes