Thienopyridine Therapy Risk Factors for Noncompliance

 

Thienopyridines are antiplatelet agents that include clopidogrel and ticlopidine.

 

Parameters:

(1) age

(2) education

(3) marital status

(4) impact of cost on health care use

(5) comorbid diseases

(6) discharge instructions

(7) referral to cardiac rehabilitation

 

A patient is more likely to discontinue thienopyridine therapy if:

(1) older

(2) does not have a high school diploma

(3) not married

(4) avoids health care because of the cost

(5) had a history of anemia or cardiovascular disease before the stent was placed

(6) did not receive discharge instructions

(7) was not referred for cardiac rehabilitation

 

where:

• There is considerable overlap in the ages of the compliant (60 +/1 12) and noncompliant (64 +/- 13) groups.

• I wonder if cost of the medications would influence the decision to discontinue the drug.

 

A patient with one or more of these risk factors should be targeted for followup to improve compliance.