- The rapid increase in cardiovascular disease determinants such as ageing are transforming healthcare needs in developing countries.
- Low cardiovascular medication adherence is associated with significantly worse outcomes, including increased risk of mortality, morbidity and healthcare costs.
- Global cardiovascular non-adherence rates are greater than 50% in developing countries, indicating a significant opportunity to improve healthcare outcomes.
Cardiovascular Diseases Are Transforming Healthcare Needs.
Changing demographics and lifestyle trends are driving an unprecedented increase in the prevalence of chronic conditions, affecting nearly half of all adults and almost 10% of children worldwide.1 Cardiovascular diseases pose a particular threat, as the leading cause of mortality globally and disproportionately affecting low- and middle-income countries.2
Cardiovascular disease determinants, such as population ageing, are manifesting dramatically in these countries: the proportion of the population over age 65 is expected to double in just two decades in Brazil, a phenomenon which took over a century in France.3 Amid these shifts, pharmacological treatments are increasingly important as effective disease management solutions but require adherence to be effective.
Non-adherence Among Cardiovascular Patients Is Significant, Even After Acute Events.
Adherence for cardiovascular treatments varies by drug class and depends on whether the treatment is indicated for either primary or secondary intervention, but they generally approximate the global adherence rate of 50%, meaning that roughly half of prescribed medications are not taken. Studies indicate a global cardiovascular adherence of 40% to 60%,4 with rates expected to be lower in developing countries.5,6
Even acute cardiac events do not necessarily improve adherence. In a study of more than 4500 post-myocardial infarction (MI) patients, 18% did not once fill their cardiac medications in the 4 months after discharge from hospital (an example of non-fulfillment). In a separate cohort of more than 22,000 post-acute coronary syndrome patients, 60% discontinued their statin medication within 2 years of hospitalization (non-persistence).7 Thus, non-adherence to cardiovascular treatments is significant.