The Pharmaceutical Journal
Vol 278 No 7434 p41
13 January 2007

This article
Reprint   Photocopy

  Acrobat Reader

News summary

Adherence/mortality link attributed to drug effect

When studies reveal an association between adherence to a medicine and survival, it is often partly attributed to the healthy adherer effect, where adherent behaviour is linked with the adoption of healthier lifestyles. However, a study has shown that the association can be attributed to the drug's biological effect (JAMA 2007; 297:177).

Researchers examined the relationship between drug adherence and mortality following acute myocardial infarction among 31,455 patients taking at least one of three medicines — statins, beta-blockers or calcium channel blockers. The first two drug classes have documented mortality benefits post-MI whereas calcium channel blockers do not.

Dispensing data were used to measure patients’ adherence. A dose-response-type gradient was observed when different levels of adherence for both statins and beta-blockers were plotted against mortality after a median follow-up of 2.4 years. No such relationship existed for calcium channel blockers.

“The beneficial biological effects associated with higher drug adherence on survival underscores the need to optimise adherent patient behaviour patterns to maximise the survival gains of evidence-based therapies,” the researchers conclude.