ABSTRACT
Medication nonadherence following hospital discharge is associated with adverse clinical outcomes. Medication nonadherence can be a result of poor-quality provider–patient interactions, polypharmacy, low health literacy, and cost, among others. The cornerstones of secondary prevention of myocardial infarction are drug therapy, cardiac rehabilitation, and lifestyle measures. Trials comparing low vs. high doses of the medications have demonstrated that optimal dosing is necessary to achieve the full clinical benefit of pharmacotherapies. Nonadherence costs the United States healthcare system over $100 billion in avoidable costs annually. Adherence is a complex series of behaviors composed of three phases: beginning a new medication; continuing to take a medication as prescribed over time; and stopping a medication for any reason. Systematic review of recently published randomized controlled trials targeting medication adherence revealed effective intervention strategies including the following: facilitating patient–provider communication, and using mobile health technologies with emphasis on two-way communication.
