It sounds simple enough on paper: When you have a chronic condition like coronary artery disease (also known as CAD), it’s important to take your medications as prescribed to best manage your symptoms and to reduce the chance that your condition could get worse. But we all know that the realities of daily life sometimes get in the way of the best intentions—even those that involve our health.
If you’ve been prescribed medication for CAD but don’t follow your doctor’s orders (what’s known as medication nonadherence), you’re not alone. In fact, it’s estimated that 50 percent of people with chronic conditions don’t take their prescription medications as directed and about 60 percent of those with cardiovascular disease don’t adhere to their prescribed treatment plans.
What are some of the reasons we might not be sticking to our prescriptions?
- Economic limitations: Let’s face it: even with a drug benefit plan, prescription medications can be expensive. A strict budget or fixed income, inadequate insurance coverage, lack of transportation and the high cost of care prevent many people from getting the medications they need to treat their coronary artery disease.
- Confusing instructions: If you’re taking several medications for one condition—or, to make things even more complex, for multiple conditions—it can be difficult to remember when to take your meds and how to administer each treatment. For example, some medications should be taken with food, others on an empty stomach and various drugs need to be taken on different timetables throughout the day. To top things off, prescription instructions are not always written in the clearest language. Difficulty following prescriptions may lead some to stop taking their medications entirely.
- Challenges navigating the healthcare system: Between doctors’ visits, insurance claims, multiple prescriptions—not to mention sometimes complicated instructions from healthcare providers and insurance companies—it can be a challenge to properly fill, refill and take your prescriptions.
- Concerns about side effects: Like any prescription drugs, those used to treat heart conditions come with the potential for side effects. And when you’re taking a medication to treat a condition that has no outward symptoms (such as high cholesterol or high blood pressure), the benefits of the drug may not be as apparent to you as those side effects you might feel on a daily basis. The perception that the risks of taking a drug outweigh its benefits may lead some to stop taking their medication prematurely.
If you have any difficulties with or questions about your prescription, it’s essential to start by consulting with your doctor or your doctor’s staff. There are no bad questions to ask. If side effects from a medication are a problem, your doctor may be able to switch you to a different drug.
The downsides of not following your prescriptions for coronary artery disease can be profound—for your health, your finances and potentially the healthcare system as a whole. Here’s how.
The health risks linked to nonadherence
Coronary artery disease—a condition characterized by a buildup of plaque in the arteries that supply blood to the heart—is linked to several serious related conditions (known as comorbidities). CAD can cause extreme pain and discomfort in the chest, but many patients have no symptoms. The condition is linked to high blood pressure, heart attack, stroke and even death.
Your doctor may recommend certain prescription medications—along with heart-healthy lifestyle habits—to better manage your coronary artery disease and its many comorbidities. When it comes to cardiovascular disease, taking any medications you may have been prescribed is vital. Here’s why:
- Statins, ezetimibe and PCSK9 inhibitors can lower levels of LDL (“bad”) cholesterol and reduce the risk of cardiovascular events like heart attacks and strokes.
- Beta blockers are commonly prescribed to slow the heart rate and reduce high blood pressure, and it’s been proven that beta blockers can help prevent subsequent heart attacks.
- Aspirin and clopidogrel are used to thin the blood and prevent the development of dangerous blood clots.
- Blood vessel dilating agents help improve the heart’s muscle function and relax blood vessels so blood can move through the body and to the heart more efficiently.
According to one study, patients with high rates of adherence (in other words, those who most closely followed their prescriptions) had a significantly lower risk of experiencing a cardiovascular event, like a heart attack. On the other hand, another study found that those who had a heart attack and did not fill their prescriptions within 120 days of the event had an 80 percent increased risk of death; those who filled only some of their prescriptions had a 44 percent increased risk.
The bottom line? If you have coronary artery disease, adhering to your medication won’t just curb uncomfortable symptoms or keep comorbidities under control—it could actually save your life.
The financial risks linked to nonadherence
Even for those with adequate health insurance, planned and unplanned medical care can be extremely expensive, and the costs are climbing. National spending on healthcare reached a whopping $3.3 trillion in 2016—or approximately $10,348 per person in the United States—and it’s projected to reach $5.7 trillion by 2026.
How can you avoid additional spending on healthcare in the coming years? Adhering to your prescription medications for coronary artery disease can help prevent unexpected medical costs—as well as the need for additional or more complicated treatments—by keeping your CAD symptoms and comorbidities under control.
One research review published in 2013 in The American Journal of Medicine suggested that closely following prescriptions for CAD not only improved health outcomes but may also reduce the annual cost associated with the disease by up to $868 per patient.
What’s more, while medication adherence is certainly a personal matter, it’s also a major public health issue. Complications and avoidable healthcare costs linked to medication nonadherence make up about $300 billion (or 10 percent) of total national spending on healthcare. By closely following your doctor’s instructions for treating your CAD, you can not only better manage your own condition and help avoid unexpected, expensive medical treatments—but you can also play a role in reducing the societal costs of healthcare.
If you have coronary artery disease, your doctor will most likely recommend healthy lifestyle changes coupled with prescription medications to manage your condition and any related complications. It’s vital to follow your doctor’s treatment plan—and ask questions whenever you are unsure of any details of that plan—so you can take control of your CAD and improve your heart health.
