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- ASCVD is a type of heart disease and a leading cause of death in the U.S. and worldwide.
- The disease is often managed through medication and lifestyle changes. Understanding why patients do or don't adhere to their ASCVD medication is key to improving outcomes.
- A new Providence study 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 is often managed through medication and lifestyle changes, but patients must receive and follow the recommended treatments. Understanding why patients adhere to or don't adhere to ASCVD medication is key to improving patient outcomes.
To answer this question, several research teams from the Providence Research Network worked together to conduct a multi-method study. Their research reveals insights and potential strategies for health systems and providers to support better medication adherence—from addressing unmet social needs to enhancing patient-provider communication.
Read on to learn more about key findings from this work, or check out the paper in the journal Progress in Cardiovascular Diseases.
Communication, social needs and other factors influence medication adherence
This study of 332 patients diagnosed with ASCVD and 122 prescribing doctors revealed several factors that influence adherence to lipid-lowering medications for ASCVD (LLMs, such as atorvastatin). Additional interviews with 23 of the study participants provided deeper insights. Here's what they found.
Gaps in patient-provider perspectives: A striking finding from the study was that many participants weren’t aware they had ASCVD. Only 16.8% of those surveyed knew of their diagnosis, despite it being documented in their medical records.
"Among the ASCVD patients that we surveyed, many were not aware of their ASCVD diagnosis," explains Eleni Wilson, senior clinical program manager for the Providence Heart Institute and one of the paper's co-authors. "There are a variety of potential reasons for this, but we believe this finding highlights opportunities to improve patient communication through standardized patient engagement pathways tailored to their disease state and associated treatment."
Social & economic needs also played a role. Patients who were not adherent were more likely to report unmet social needs. Efforts to address broader social determinants of health could help improve medication adherence.
Healthcare experiences: Positive healthcare experiences were linked with improved 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. Interviewees trust their providers when it comes to determining what's best for their health and making the most effective medication and treatment plan. For very high-risk patients, those who reported that their providers explained things clearly had a lower risk of non-adherence.
Takeaways for providers and healthcare systems
Together, these insights support a holistic approach to cardiovascular care that addresses medical, social, and human needs to improve outcomes. By enhancing patient-provider communication, addressing social determinants of health, and supporting providers, we can make significant strides in patient care.
More about the study
This work was funded by AMGEN and conducted in partnership with the Providence Heart Institute, Providence Center for Cardiovascular Analytics, Research + Data Science (CARDS), the Center for Outcomes Research & Education (CORE) and the Providence Health Research Accelerator.
Read the full paper at Progress in Cardiovascular Diseases.
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