Adherence to management low, waning in aortic aneurysm patients

Patients with aortic aneurysms show “very low” adherence to medical management, which also differs by subtype and declines over time, reveals a study.

“Levels of adherence in those with aortic aneurysms are significantly lower compared to those with coronary artery disease (CAD),” the authors said. “This should prove a reasonable target for implementation initiatives.”

This study enrolled and probed adult patients with an aortic aneurysm or CAD diagnosed between 2004 and 2018 in the Optum Clinformatics deidentified Datamart. The authors categorized aneurysms as thoracic, abdominal, or both. They also verified receipt of an antihypertensive or antihyperlipidaemic medications through pharmacy claims.

Adherence was defined as receipt of the indicated pharmacologic treatment following a diagnosis of aneurysm or CAD. The authors compared adherence between patients with aneurysms and those with CAD using univariable logistic regression.

A total of 194,144 patients with an aortic aneurysm and 3,946,782 with CAD met the eligibility criteria. Overall adherence was low at 45.0 percent. It also differed significantly by subtype, which was highest in isolated thoracic (45.9 percent) and lowest in isolated abdominal aneurysms (42.6 percent).

Adherence levels also dropped substantially after a year by nearly 15 percent in each subtype. In addition, all aneurysm subtypes showed a lower likelihood of adherence relative to CAD, with odds ranging from 0.61 in patients with isolated abdominal to 0.80 with isolated thoracic aneurysms.