• Am. J. Med. · Oct 2022

    National Adherence To Medical Management of Aortic Aneurysms.

    • William L Patrick, Fabliha Khurshan, Joseph E Bavaria, Yu Zhao, Peter W Groeneveld, Siddharth Yarlagadda, Jake L Rosen, Joshua C Grimm, Wilson Y Szeto, and Nimesh D Desai.
    • Division of Cardiovascular Surgery, University of Pennsylvania, Philadelphia; Leonard Davis Institute, University of Pennsylvania, Philadelphia; Penn Cardiovascular Outcomes, Quality, & Evaluative Research Center, Philadelphia, Penn. Electronic address: williamlpatrick@gmail.com.
    • Am. J. Med. 2022 Oct 1; 135 (10): 12021212.e41202-1212.e4.

    ObjectivesThe purpose of this study was to describe levels of adherence to guideline-based medical management in patients with aortic aneurysms, using an analogous population with coronary artery disease as a comparator. Adherence among those with aortic aneurysms has never been studied.MethodsAdult patients with an aortic aneurysm or coronary artery disease diagnosed between 2004 and 2018 in the Optum Clinformatics deidentified Datamart were queried. Aneurysms were subclassified as thoracic, abdominal, or both. Receipt of an antihypertensive or antihyperlipidemic was determined through pharmacy claims. Adherence was determined as receipt of the indicated pharmacologic(s) after a diagnosis of aneurysm or coronary artery disease. Adherence was compared between those with aneurysms and coronary disease using univariable logistic regression.ResultsAfter exclusions, 194,144 patients with an aortic aneurysm and 3,946,782 with coronary artery disease were identified. Overall adherence was low (45.0%) and differed significantly by aneurysm subtype: highest in isolated thoracic (45.9%) and lowest in isolated abdominal aneurysms (42.6%). Adherence levels declined significantly after 1 year by about 15% in each aneurysm subtype. All subtypes of aneurysm had a significantly lower odds of adherence compared to those with coronary disease with odds ranging from 0.61 in those with isolated abdominal aneurysms to 0.80 with isolated thoracic aneurysms.ConclusionsAdherence among those with aortic aneurysms is very low, differs by subtype, and declines with time. Levels of adherence in those with aortic aneurysms is significantly lower compared to those with coronary artery disease. This should prove a reasonable target for implementation initiatives.Copyright © 2022 Elsevier Inc. All rights reserved.

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