One-year care pathway after acute myocardial infarction in 2018: Prescription, medical care and medication adherence, using a French health insurance reimbursement database

•Description of the 2018 myocardial infarction care pathway after discharge from hospital.•Patients consult their general practitioner extensively after hospital discharge.•Forty-five percent of patients that go to a cardiac rehabilitation center show improved adherence.•Medication adherence remains...

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Veröffentlicht in:Archives of cardiovascular diseases 2022-02, Vol.115 (2), p.78-86
Hauptverfasser: Martin-Latry, Karin, Latry, Philippe, Berges, Camille, Coste, Pierre, Douard, Hervé, Pucheu, Yann, Couffinhal, Thierry
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container_end_page 86
container_issue 2
container_start_page 78
container_title Archives of cardiovascular diseases
container_volume 115
creator Martin-Latry, Karin
Latry, Philippe
Berges, Camille
Coste, Pierre
Douard, Hervé
Pucheu, Yann
Couffinhal, Thierry
description •Description of the 2018 myocardial infarction care pathway after discharge from hospital.•Patients consult their general practitioner extensively after hospital discharge.•Forty-five percent of patients that go to a cardiac rehabilitation center show improved adherence.•Medication adherence remains suboptimal during the first year. Myocardial infarction is a major cause of morbidity and mortality. Guidelines have been published to optimize medical care and involve optimization of the care pathway and hospital-city coordination. To describe the myocardial infarction care pathway during the year following hospital discharge, and the use of and adherence to secondary prevention drugs. A cohort study was conducted using data from the main French health insurance reimbursement database of the ex-Aquitaine region. Information about the medical and pharmaceutical care of hospitalized patients in 2018 was collected for 12 months. Medication adherence was assessed by using the proportion of days covered by the treatment and persistence. A total of 3015 patients were included, and the mean age was 66 years. Almost 76% of the patients had a reimbursement for BAS (combined prescription of beta-blocker/antiplatelet/lipid-lowering drug), BASI (combined prescription of beta-blocker/antiplatelet/lipid-lowering drug/angiotensin-converting enzyme inhibitor) or AS (combined prescription of antiplatelet/lipid-lowering drug) treatment. Medication adherence was around 83% for aspirin and 75% for lipid-lowering drugs for the 1-year persistence. During the same time, the proportion of days covered was suboptimal. Almost 4% of patients died after leaving hospital, 45% went to a cardiac rehabilitation centre and 23% had at least one hospital readmission, whatever the reason. Patients had a mean number of 11 general practitioner consultations during the year. Almost 41% of patients did not have a consultation with a cardiologist, and 38.4% had at least two consultations. Rehabilitation and general practitioner consultations were associated with adherence. These new results provide clear information on the medical care environment of patients, and help us to improve care transition. Close collaboration between healthcare practitioners is very important in the early stages of outpatient follow-up. L’infarctus du myocarde (IDM) reste une cause majeure de morbi/mortalité. Décrire le parcours de soins de l’IDM en 2018 pendant l’année suivant la sortie de l’hôpital et l’utilisation et l’
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Myocardial infarction is a major cause of morbidity and mortality. Guidelines have been published to optimize medical care and involve optimization of the care pathway and hospital-city coordination. To describe the myocardial infarction care pathway during the year following hospital discharge, and the use of and adherence to secondary prevention drugs. A cohort study was conducted using data from the main French health insurance reimbursement database of the ex-Aquitaine region. Information about the medical and pharmaceutical care of hospitalized patients in 2018 was collected for 12 months. Medication adherence was assessed by using the proportion of days covered by the treatment and persistence. A total of 3015 patients were included, and the mean age was 66 years. Almost 76% of the patients had a reimbursement for BAS (combined prescription of beta-blocker/antiplatelet/lipid-lowering drug), BASI (combined prescription of beta-blocker/antiplatelet/lipid-lowering drug/angiotensin-converting enzyme inhibitor) or AS (combined prescription of antiplatelet/lipid-lowering drug) treatment. Medication adherence was around 83% for aspirin and 75% for lipid-lowering drugs for the 1-year persistence. During the same time, the proportion of days covered was suboptimal. Almost 4% of patients died after leaving hospital, 45% went to a cardiac rehabilitation centre and 23% had at least one hospital readmission, whatever the reason. Patients had a mean number of 11 general practitioner consultations during the year. Almost 41% of patients did not have a consultation with a cardiologist, and 38.4% had at least two consultations. Rehabilitation and general practitioner consultations were associated with adherence. These new results provide clear information on the medical care environment of patients, and help us to improve care transition. Close collaboration between healthcare practitioners is very important in the early stages of outpatient follow-up. L’infarctus du myocarde (IDM) reste une cause majeure de morbi/mortalité. Décrire le parcours de soins de l’IDM en 2018 pendant l’année suivant la sortie de l’hôpital et l’utilisation et l’adhésion des médicaments de prévention secondaire. Les patients hospitalisés pour un IDM en 2018 ont été identifiés. Leurs soins médicaux et leurs médicaments au cours des 12 mois suivants ont été analysés à partie de la base de données de remboursement de l’assurance maladie française de la région ex-Aquitaine. L’adhésion au traitement a été évaluée en utilisant la proportion de jours couverts par le traitement et la persistance. Au total, 3015 patients ont été inclus avec un âge moyen de 66 ans. Près de 76 % des patients ont eu un remboursement pour un traitement BAS, BASI ou AS. La persistance à un an était de 83 % pour l’aspirine et 75 % pour les hypolipémiants, mais la proportion de jours couverts était sous-optimale. Près de 45 % des patients sont allés en centre de réadaptation et 23 % a eu au moins une réhospitalisation; 4 % des patients sont décédés après retour à domicile. Les patients ont consulté en moyenne 11 fois un médecin généraliste dans l’année. Près de 41 % des patients n’ont pas eu de remboursement de consultation chez le cardiologue de ville et 38,4 % ont eu au moins deux consultations. La réadaptation et les consultations de médecine générale sont associés à l’adhésion médicamenteuse. Ces nouveaux résultats pourraient nous aider à améliorer la transition des soins, et la collaboration entre les professionnels de santé impliqués dans un suivi ambulatoire.</description><identifier>ISSN: 1875-2136</identifier><identifier>EISSN: 1875-2128</identifier><identifier>DOI: 10.1016/j.acvd.2021.12.003</identifier><identifier>PMID: 35115266</identifier><language>eng</language><publisher>Netherlands: Elsevier Masson SAS</publisher><subject>Adhésion médicamenteuse ; Aged ; Bases de données ; Care pathway ; Cohort Studies ; Critical Pathways ; France ; Humans ; Infarctus du myocarde ; Insurance, Health, Reimbursement ; Medication Adherence ; Myocardial infarction ; Myocardial Infarction - drug therapy ; Parcours de soins ; Prescriptions</subject><ispartof>Archives of cardiovascular diseases, 2022-02, Vol.115 (2), p.78-86</ispartof><rights>2022 Elsevier Masson SAS</rights><rights>Copyright © 2022 Elsevier Masson SAS. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-218fbee9b93286b06740f8f47c2dc2a3101994a425d89654be774e96c3ac083</citedby><cites>FETCH-LOGICAL-c400t-218fbee9b93286b06740f8f47c2dc2a3101994a425d89654be774e96c3ac083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.acvd.2021.12.003$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/35115266$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Martin-Latry, Karin</creatorcontrib><creatorcontrib>Latry, Philippe</creatorcontrib><creatorcontrib>Berges, Camille</creatorcontrib><creatorcontrib>Coste, Pierre</creatorcontrib><creatorcontrib>Douard, Hervé</creatorcontrib><creatorcontrib>Pucheu, Yann</creatorcontrib><creatorcontrib>Couffinhal, Thierry</creatorcontrib><title>One-year care pathway after acute myocardial infarction in 2018: Prescription, medical care and medication adherence, using a French health insurance reimbursement database</title><title>Archives of cardiovascular diseases</title><addtitle>Arch Cardiovasc Dis</addtitle><description>•Description of the 2018 myocardial infarction care pathway after discharge from hospital.•Patients consult their general practitioner extensively after hospital discharge.•Forty-five percent of patients that go to a cardiac rehabilitation center show improved adherence.•Medication adherence remains suboptimal during the first year. Myocardial infarction is a major cause of morbidity and mortality. Guidelines have been published to optimize medical care and involve optimization of the care pathway and hospital-city coordination. To describe the myocardial infarction care pathway during the year following hospital discharge, and the use of and adherence to secondary prevention drugs. A cohort study was conducted using data from the main French health insurance reimbursement database of the ex-Aquitaine region. Information about the medical and pharmaceutical care of hospitalized patients in 2018 was collected for 12 months. Medication adherence was assessed by using the proportion of days covered by the treatment and persistence. A total of 3015 patients were included, and the mean age was 66 years. Almost 76% of the patients had a reimbursement for BAS (combined prescription of beta-blocker/antiplatelet/lipid-lowering drug), BASI (combined prescription of beta-blocker/antiplatelet/lipid-lowering drug/angiotensin-converting enzyme inhibitor) or AS (combined prescription of antiplatelet/lipid-lowering drug) treatment. Medication adherence was around 83% for aspirin and 75% for lipid-lowering drugs for the 1-year persistence. During the same time, the proportion of days covered was suboptimal. Almost 4% of patients died after leaving hospital, 45% went to a cardiac rehabilitation centre and 23% had at least one hospital readmission, whatever the reason. Patients had a mean number of 11 general practitioner consultations during the year. Almost 41% of patients did not have a consultation with a cardiologist, and 38.4% had at least two consultations. Rehabilitation and general practitioner consultations were associated with adherence. These new results provide clear information on the medical care environment of patients, and help us to improve care transition. Close collaboration between healthcare practitioners is very important in the early stages of outpatient follow-up. L’infarctus du myocarde (IDM) reste une cause majeure de morbi/mortalité. Décrire le parcours de soins de l’IDM en 2018 pendant l’année suivant la sortie de l’hôpital et l’utilisation et l’adhésion des médicaments de prévention secondaire. Les patients hospitalisés pour un IDM en 2018 ont été identifiés. Leurs soins médicaux et leurs médicaments au cours des 12 mois suivants ont été analysés à partie de la base de données de remboursement de l’assurance maladie française de la région ex-Aquitaine. L’adhésion au traitement a été évaluée en utilisant la proportion de jours couverts par le traitement et la persistance. Au total, 3015 patients ont été inclus avec un âge moyen de 66 ans. Près de 76 % des patients ont eu un remboursement pour un traitement BAS, BASI ou AS. La persistance à un an était de 83 % pour l’aspirine et 75 % pour les hypolipémiants, mais la proportion de jours couverts était sous-optimale. Près de 45 % des patients sont allés en centre de réadaptation et 23 % a eu au moins une réhospitalisation; 4 % des patients sont décédés après retour à domicile. Les patients ont consulté en moyenne 11 fois un médecin généraliste dans l’année. Près de 41 % des patients n’ont pas eu de remboursement de consultation chez le cardiologue de ville et 38,4 % ont eu au moins deux consultations. La réadaptation et les consultations de médecine générale sont associés à l’adhésion médicamenteuse. 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Myocardial infarction is a major cause of morbidity and mortality. Guidelines have been published to optimize medical care and involve optimization of the care pathway and hospital-city coordination. To describe the myocardial infarction care pathway during the year following hospital discharge, and the use of and adherence to secondary prevention drugs. A cohort study was conducted using data from the main French health insurance reimbursement database of the ex-Aquitaine region. Information about the medical and pharmaceutical care of hospitalized patients in 2018 was collected for 12 months. Medication adherence was assessed by using the proportion of days covered by the treatment and persistence. A total of 3015 patients were included, and the mean age was 66 years. Almost 76% of the patients had a reimbursement for BAS (combined prescription of beta-blocker/antiplatelet/lipid-lowering drug), BASI (combined prescription of beta-blocker/antiplatelet/lipid-lowering drug/angiotensin-converting enzyme inhibitor) or AS (combined prescription of antiplatelet/lipid-lowering drug) treatment. Medication adherence was around 83% for aspirin and 75% for lipid-lowering drugs for the 1-year persistence. During the same time, the proportion of days covered was suboptimal. Almost 4% of patients died after leaving hospital, 45% went to a cardiac rehabilitation centre and 23% had at least one hospital readmission, whatever the reason. Patients had a mean number of 11 general practitioner consultations during the year. Almost 41% of patients did not have a consultation with a cardiologist, and 38.4% had at least two consultations. Rehabilitation and general practitioner consultations were associated with adherence. These new results provide clear information on the medical care environment of patients, and help us to improve care transition. Close collaboration between healthcare practitioners is very important in the early stages of outpatient follow-up. L’infarctus du myocarde (IDM) reste une cause majeure de morbi/mortalité. Décrire le parcours de soins de l’IDM en 2018 pendant l’année suivant la sortie de l’hôpital et l’utilisation et l’adhésion des médicaments de prévention secondaire. Les patients hospitalisés pour un IDM en 2018 ont été identifiés. Leurs soins médicaux et leurs médicaments au cours des 12 mois suivants ont été analysés à partie de la base de données de remboursement de l’assurance maladie française de la région ex-Aquitaine. L’adhésion au traitement a été évaluée en utilisant la proportion de jours couverts par le traitement et la persistance. Au total, 3015 patients ont été inclus avec un âge moyen de 66 ans. Près de 76 % des patients ont eu un remboursement pour un traitement BAS, BASI ou AS. La persistance à un an était de 83 % pour l’aspirine et 75 % pour les hypolipémiants, mais la proportion de jours couverts était sous-optimale. Près de 45 % des patients sont allés en centre de réadaptation et 23 % a eu au moins une réhospitalisation; 4 % des patients sont décédés après retour à domicile. Les patients ont consulté en moyenne 11 fois un médecin généraliste dans l’année. Près de 41 % des patients n’ont pas eu de remboursement de consultation chez le cardiologue de ville et 38,4 % ont eu au moins deux consultations. La réadaptation et les consultations de médecine générale sont associés à l’adhésion médicamenteuse. Ces nouveaux résultats pourraient nous aider à améliorer la transition des soins, et la collaboration entre les professionnels de santé impliqués dans un suivi ambulatoire.</abstract><cop>Netherlands</cop><pub>Elsevier Masson SAS</pub><pmid>35115266</pmid><doi>10.1016/j.acvd.2021.12.003</doi><tpages>9</tpages><oa>free_for_read</oa></addata></record>
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subjects Adhésion médicamenteuse
Aged
Bases de données
Care pathway
Cohort Studies
Critical Pathways
France
Humans
Infarctus du myocarde
Insurance, Health, Reimbursement
Medication Adherence
Myocardial infarction
Myocardial Infarction - drug therapy
Parcours de soins
Prescriptions
title One-year care pathway after acute myocardial infarction in 2018: Prescription, medical care and medication adherence, using a French health insurance reimbursement database
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