• ASCVD is a type of heart disease and a leading cause of death in the U.S. and worldwide.
• The condition is often managed through medication and lifestyle changes. Understanding why patients do or don't adhere to their medication treatments is key to better outcomes.
• A new Providence study co-authored by CORE found links between adherence to ASCVD treatment, negative healthcare experiences, patient-provider communication, and unmet social needs. 

Atherosclerotic cardiovascular disease (ASCVD) is a form of heart disease and a leading cause of death in the U.S. and worldwide. It can often be managed through medication and lifestyle changes, but patients must receive and follow the recommended treatments. Understanding why patients do or don't adhere to their medication treatments is key to helping more people benefit from them.

New Providence research supported by the Center for Outcomes Research and Education (CORE) found that patient experiences with healthcare, communication with providers, and unmet social needs can all impact medication adherence. The study also uncovered notable gaps between providers’ perceptions and patients’ understanding of their diagnoses.

Read on to learn more about key findings from this work. For a deeper dive, check out our paper in the journal Progress in Cardiovascular Diseases.

Key findings and drivers of ASCVD treatment adherence 

This study of 332 patients with an ASCVD diagnosis and 122 prescribing doctors at the Providence health system revealed several key factors that influence adherence to lipid-lowering medications (LLMs, such as atorvastatin). This work was funded by AMGEN and conducted in partnership with the Providence Center for Cardiovascular Analytics, Research + Data Science (CARDS) and the Providence Health Research Accelerator. CORE also conducted interviews with 23 of the study participants to gain deeper insight into their perspectives on medication adherence.

Healthcare experiences: Positive healthcare experiences were linked to better medication adherence. Patients who felt their providers consistently gave them enough time and respect were more likely to take their medications as prescribed.

Patient-provider communication: Patients in this study viewed their healthcare providers as trusted sources of information about their healthcare and treatments. Patient interviews reinforced this theme. Interviewees described the trust they place in their provider around what’s best for their health, including making the best medication and treatment plan.  
And for very high-risk patients, those who reported that their providers explained things clearly had a lower risk of non-adherence. 

“I'm very, very comfortable with him. He knows me, he knows my history. I've got a good rapport with him. I basically trust him with my life. I never question him. If he thinks that I need to have this or that or whatever test he wants done, there's a reason for it and I never questioned him why. Quite frankly, I feel that he saved my life.”- Very high risk ASCVD patient 

Gaps in patient-provider perspectives: A striking finding was that many participants were unaware they had ASCVD. Only 16.8% knew of their diagnosis, despite it being documented in their medical records. In addition, providers often had less confidence in their patients’ adherence than patients themselves. These results highlight the opportunity to strengthen patient education and communication.

Social Determinants of Health: Social and economic needs also played a role. Patients who were not adherent were more likely to report unmet social needs. Addressing broader social determinants may help improve medication adherence.

Takeaways for providers and healthcare systems 

"As healthcare systems work to improve ASCVD outcomes, this research points to several clear priorities,” explains Sarah Roth, research scientist at CORE. “They include strengthening patient-provider communication, addressing social determinants of health, and supporting providers so that they can provide sufficient time, information, and respect in every interaction.”  

Together, these insights support a holistic approach to cardiovascular care—one that addresses medical, social, and human needs to improve outcomes.