Pink tablets made into a heart shape

Almost 60% of heart patients are not taking their medicine as prescribed

This Heart Awareness Month, patients are being urged to take their medication as prescribed to avoid preventable deaths and hospitalisations.

According to a study published in the Journal of South African Family Practice, only 41.9% of heart patients are adhering to antihypertensive treatment regimes, which is extremely low when juxtaposed against the 90% adherence rate among HIV-positive patients on antiretrovirals.

After HIV/Aids, cardiovascular disease (CVD) is the leading cause of death in South Africa, with one in three people over the age of 25 suffering from hypertension (high blood pressure), which makes the diagnosis and management of the disease early on so important. 

Nicole Jennings, spokesperson for Pharma Dynamics – South Africa’s leading provider of cardiovascular medicine – says non-adherence to prescribed medicine regimens is a pervasive medical problem, which is costing many people their health and the healthcare system billions of rands. 

“While there is much room for improvement, addressing medication non-adherence is a complex issue that requires a multifaceted approach.”

She cites cost, complex regimes, forgetfulness, lack of understanding, and psychological factors as some common reasons heart patients may not be taking their hypertensive medication.

“Not taking medication as prescribed can have serious consequences, especially for individuals with cardiovascular diseases. “Non-adherence also increases the risk of hospitalisation by 10%–40% and the risk of mortality by 50%–80%.”

Other consequences may include: 

Increased risk of heart events: Failure to take heart medications as prescribed can significantly increase the risk of heart-related events such as heart attacks, strokes and unstable angina. Medications like angiotensin-converting enzyme (ACE inhibitors), anti-platelet drugs, beta-blockers and anticoagulants are often prescribed to prevent these events.

Worsening of heart disease: Cardiovascular medications are typically prescribed to manage and stabilise heart diseases such as hypertension, heart failure and arrhythmias. Non-adherence can lead to the progression of these conditions, resulting in more severe symptoms and complications.

Hospitalisation: Medication non-adherence can lead to exacerbations of heart conditions, which may require hospitalisation. Heart failure patients, for example, may experience fluid buildup in the lungs (pulmonary oedema) or other complications that necessitate urgent medical attention.

Reduced quality of life: Uncontrolled heart disease can lead to symptoms like chest pain, shortness of breath, fatigue and decreased exercise tolerance. These symptoms can significantly reduce a person’s quality of life and ability to perform daily activities.

Increased healthcare costs: Non-adherence can result in more frequent doctor visits, hospitalisations and additional medical interventions, leading to higher healthcare costs for both individuals and the healthcare system. 

Complications in other organs: CVD can impact other organs and systems in the body. For example, untreated hypertension can damage the kidneys, eyes and blood vessels. Non-adherence can exacerbate these complications. 

Increased mortality risk: Ultimately, non-adherence to heart medications can increase the risk of premature death, especially in cases of severe heart disease. 

Jennings says healthcare providers play a crucial role in educating patients about the importance of their medications, discussing potential side effects and concerns, simplifying regimens when possible and exploring cost-effective options. 

“As the county’s leading provider of heart medicine, we have a robust strategy in place to bring more cost-effective, combination therapies to the local market. Lessening the pill-burden for patients who need to take two or more types of medication per day in one way to improve adherence.

“It’s important to note that while medication adherence is a critical factor, other lifestyle changes and risk factor management (e.g. diet, exercise, smoking cessation, limiting alcohol intake) also play a crucial role in reducing hospitalisations in heart patients. Therefore, a comprehensive approach to heart disease management is essential,” she says.

Jennings concludes by referring patients to the MyDynamics platform where additional resources to manage lifestyle change can be accessed.

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