Long-term adherence and persistence to low-dose aspirin for cardiovascular disease prevention were suboptimal, with 10-year persistence ranging from 32.1% to 46.8% across Germany and the UK.
Cohort (n=335,624)
Yes
What is the long-term adherence and persistence to low-dose aspirin for primary and secondary prevention of cardiovascular disease?
Long-term adherence and persistence to low-dose aspirin for CVD prevention are suboptimal, highlighting a need for interventions to improve long-term use.
Background and Aim . Adherence and persistence to low‐dose aspirin are key to maximising its cardiovascular benefits in patients with a history of cardiovascular disease (CVD) or those at high CVD risk; however, few studies have provided population‐based estimates of its long‐term (>2–3 years) use. We aimed to determine long‐term (up to 10 years) adherence and persistence to low‐dose aspirin for primary/secondary prevention of CVD. Methods . Using information from electronic health records in Germany and the United Kingdom (UK) in a common data model, we followed adults with ≥2 low‐dose aspirin prescriptions (75–100 mg) during 2007–2018 for up to 10 years. Included individuals had no low‐dose aspirin prescriptions in the year before the follow‐up started (date of first low‐dose aspirin prescription) and ≥12 months’ observation. Adherence was determined using the medication possession ratio (MPR), and persistence was defined as continuous treatment disregarding gaps between prescriptions of <60 days; analyses were undertaken according to indication (primary/secondary CVD prevention). Results . We identified 144,717 low‐dose aspirin users from Germany and 190,907 from the UK. Among patients with 5–10 years’ follow‐up, median adherence among secondary CVD prevention users was 60% in Germany and 75% in the UK. Among primary prevention users, median adherence was 50% for both countries. Persistence among secondary CVD prevention users was 58.3% at 2 years, 47.0% at 5 years, 35.2% at 10 years (Germany), and 67.5% at 2 years, 58.0% at 5 years, and 46.8% at 10 years (UK). Among primary CVD prevention users, persistence was 52.8% at 2 years, 41.6% at 5 years, 32.1% at 10 years (Germany), 56.3% at 2 years, 45.4% at 5 years, and 33.8% at 10 years (UK). Conclusions . Long‐term adherence and persistence to low‐dose aspirin are suboptimal; efforts for improvement could translate into a lower CVD burden in the general population.
Vora et al. (Sat,) conducted a cohort in Cardiovascular disease prevention (n=335,624). Low-dose aspirin was evaluated on Adherence (medication possession ratio) and persistence (continuous treatment). Long-term adherence and persistence to low-dose aspirin for cardiovascular disease prevention were suboptimal, with 10-year persistence ranging from 32.1% to 46.8% across Germany and the UK.
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