The Relationship of Treatment Adherence to the Risk of Death After Myocardial Infarction in Women

E. John Gallagher, Catherine M. Viscoli, Ralph I. Horwitz

Research output: Contribution to journalArticle

128 Citations (Scopus)

Abstract

To examine the relationship between adherence to a medical regimen and mortality following a myocardial infarction in women. Analysis of the female cohort entered into a randomized double-blind multicenter trial. National Heart, Lung, and Blood Institute β-Blocker Heart Attack Trial. The 602 women, aged 30 to 69 years, enrolled in the β-Blocker Heart Attack Trial. Random assignment to propranolol hydrochloride or placebo 5 to 21 days following a myocardial infarction. Adherence for each patient was calculated as the mean of all quarterly adherence estimates during the course of the trial (median follow-up, 26 months). Adherence was classified as good (taking ≥75% of medication) or poor (taking <75% of medication). The end point was death from all causes occurring at any time during the trial, adjusted for treatment category and other clinical and sociodemographic features. Adherence data were available on 505 women, of whom 32 (6.3%) died. Death occurred in 13.6% of poor adherers compared with 5.6% of good adherers (relative risk, 2.4; 95% confidence interval, 1.1 to 5.6). The effect of adherence on mortality remained undiminished after adjustment for treatment category (propranolol or placebo), age, severity of myocardial infarction, congestive heart failure, smoking history, marital status, educational level, and race (adjusted relative risk of death for poor adherers, 2.5 to 3.0; P≤.02). The independent effect of adherence on mortality following a myocardial infarction in women is clinically substantial, statistically significant, and similar in magnitude to that reported earlier for men.

Original languageEnglish (US)
Pages (from-to)742-744
Number of pages3
JournalJAMA - Journal of the American Medical Association
Volume270
Issue number6
DOIs
StatePublished - Aug 11 1993
Externally publishedYes

Fingerprint

Myocardial Infarction
Propranolol
Mortality
Therapeutics
Placebos
National Heart, Lung, and Blood Institute (U.S.)
Marital Status
Patient Compliance
Multicenter Studies
Cause of Death
Cohort Studies
Heart Failure
Smoking
History
Confidence Intervals

ASJC Scopus subject areas

  • Medicine(all)

Cite this

The Relationship of Treatment Adherence to the Risk of Death After Myocardial Infarction in Women. / Gallagher, E. John; Viscoli, Catherine M.; Horwitz, Ralph I.

In: JAMA - Journal of the American Medical Association, Vol. 270, No. 6, 11.08.1993, p. 742-744.

Research output: Contribution to journalArticle

@article{11f56dc95d924a828de07b05427c2c82,
title = "The Relationship of Treatment Adherence to the Risk of Death After Myocardial Infarction in Women",
abstract = "To examine the relationship between adherence to a medical regimen and mortality following a myocardial infarction in women. Analysis of the female cohort entered into a randomized double-blind multicenter trial. National Heart, Lung, and Blood Institute β-Blocker Heart Attack Trial. The 602 women, aged 30 to 69 years, enrolled in the β-Blocker Heart Attack Trial. Random assignment to propranolol hydrochloride or placebo 5 to 21 days following a myocardial infarction. Adherence for each patient was calculated as the mean of all quarterly adherence estimates during the course of the trial (median follow-up, 26 months). Adherence was classified as good (taking ≥75{\%} of medication) or poor (taking <75{\%} of medication). The end point was death from all causes occurring at any time during the trial, adjusted for treatment category and other clinical and sociodemographic features. Adherence data were available on 505 women, of whom 32 (6.3{\%}) died. Death occurred in 13.6{\%} of poor adherers compared with 5.6{\%} of good adherers (relative risk, 2.4; 95{\%} confidence interval, 1.1 to 5.6). The effect of adherence on mortality remained undiminished after adjustment for treatment category (propranolol or placebo), age, severity of myocardial infarction, congestive heart failure, smoking history, marital status, educational level, and race (adjusted relative risk of death for poor adherers, 2.5 to 3.0; P≤.02). The independent effect of adherence on mortality following a myocardial infarction in women is clinically substantial, statistically significant, and similar in magnitude to that reported earlier for men.",
author = "Gallagher, {E. John} and Viscoli, {Catherine M.} and Horwitz, {Ralph I.}",
year = "1993",
month = "8",
day = "11",
doi = "10.1001/jama.1993.03510060088038",
language = "English (US)",
volume = "270",
pages = "742--744",
journal = "JAMA - Journal of the American Medical Association",
issn = "0002-9955",
publisher = "American Medical Association",
number = "6",

}

TY - JOUR

T1 - The Relationship of Treatment Adherence to the Risk of Death After Myocardial Infarction in Women

AU - Gallagher, E. John

AU - Viscoli, Catherine M.

AU - Horwitz, Ralph I.

PY - 1993/8/11

Y1 - 1993/8/11

N2 - To examine the relationship between adherence to a medical regimen and mortality following a myocardial infarction in women. Analysis of the female cohort entered into a randomized double-blind multicenter trial. National Heart, Lung, and Blood Institute β-Blocker Heart Attack Trial. The 602 women, aged 30 to 69 years, enrolled in the β-Blocker Heart Attack Trial. Random assignment to propranolol hydrochloride or placebo 5 to 21 days following a myocardial infarction. Adherence for each patient was calculated as the mean of all quarterly adherence estimates during the course of the trial (median follow-up, 26 months). Adherence was classified as good (taking ≥75% of medication) or poor (taking <75% of medication). The end point was death from all causes occurring at any time during the trial, adjusted for treatment category and other clinical and sociodemographic features. Adherence data were available on 505 women, of whom 32 (6.3%) died. Death occurred in 13.6% of poor adherers compared with 5.6% of good adherers (relative risk, 2.4; 95% confidence interval, 1.1 to 5.6). The effect of adherence on mortality remained undiminished after adjustment for treatment category (propranolol or placebo), age, severity of myocardial infarction, congestive heart failure, smoking history, marital status, educational level, and race (adjusted relative risk of death for poor adherers, 2.5 to 3.0; P≤.02). The independent effect of adherence on mortality following a myocardial infarction in women is clinically substantial, statistically significant, and similar in magnitude to that reported earlier for men.

AB - To examine the relationship between adherence to a medical regimen and mortality following a myocardial infarction in women. Analysis of the female cohort entered into a randomized double-blind multicenter trial. National Heart, Lung, and Blood Institute β-Blocker Heart Attack Trial. The 602 women, aged 30 to 69 years, enrolled in the β-Blocker Heart Attack Trial. Random assignment to propranolol hydrochloride or placebo 5 to 21 days following a myocardial infarction. Adherence for each patient was calculated as the mean of all quarterly adherence estimates during the course of the trial (median follow-up, 26 months). Adherence was classified as good (taking ≥75% of medication) or poor (taking <75% of medication). The end point was death from all causes occurring at any time during the trial, adjusted for treatment category and other clinical and sociodemographic features. Adherence data were available on 505 women, of whom 32 (6.3%) died. Death occurred in 13.6% of poor adherers compared with 5.6% of good adherers (relative risk, 2.4; 95% confidence interval, 1.1 to 5.6). The effect of adherence on mortality remained undiminished after adjustment for treatment category (propranolol or placebo), age, severity of myocardial infarction, congestive heart failure, smoking history, marital status, educational level, and race (adjusted relative risk of death for poor adherers, 2.5 to 3.0; P≤.02). The independent effect of adherence on mortality following a myocardial infarction in women is clinically substantial, statistically significant, and similar in magnitude to that reported earlier for men.

UR - http://www.scopus.com/inward/record.url?scp=0027293786&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027293786&partnerID=8YFLogxK

U2 - 10.1001/jama.1993.03510060088038

DO - 10.1001/jama.1993.03510060088038

M3 - Article

C2 - 8336377

AN - SCOPUS:0027293786

VL - 270

SP - 742

EP - 744

JO - JAMA - Journal of the American Medical Association

JF - JAMA - Journal of the American Medical Association

SN - 0002-9955

IS - 6

ER -