O36: Patient acceptability and adherence to the COMPASS trial drug recommendations following symptomatic carotid endarterectomy (CEA)

Introduction The COMPASS trial demonstrated that in patients with atherosclerotic diseases, low-dose rivaroxaban and aspirin provides greater protection against subsequent cardiovascular events than antiplatelet monotherapy (MAPT) alone. Medication adherence is necessary to maximise this benefit and is dependent on patient views. We have assessed this in patients following CEA. Methods Following CEA, the views of 63 patients on the COMPASS drug regime were compared with 54 on MAPT. Views on medications was assessed using the Beliefs about Medicine Questionnaire (BMQ) and drug adherence using the Sidorkiewicz scoring system. Side effects and the incidence of new cardiovascular events were also assessed. Results Both groups had similar age (mean 70.6+/-8.7), gender (M:F 2:1), and deprivation indices. Preoperative co-morbidities were similar between groups, as were intervention indications (TIA or stroke). There was no difference (p<0.05) between the COMPASS drug regime and MAPT in BMQ for “Necessity” (19.6 v 19.1), “Concerns” (11.8v 12.0) or the “Necessity–Concerns differential”(+7.8v+7.1). Drug adherence was similar with the median showing a “High drug adherence”. The incidence of bleeding and drug reaction complications was similar. Numbers of new stroke, ischaemic cardiac events, and peripheral vascular disease diagnoses was similar, as was the combined overall major adverse cardiovascular events (MACE). Conclusions Following CEA, patients’ views on medications and their drug adherence are similar in those on the COMPASS drug regime as on MAPT. We have not identified any patient-related barriers to the use of the COMPASS drug regimen to further reduce cardiovascular events.