Evidence map›Paper›PMID 39910396›Full record

ArticleBMC cardiovascular disorders2025

Incident prescriptions for common cardiovascular medications: comparison of recent versus pre-2020 medication adherence and discontinuation in three universal health care systems.

Candace D McNaughton, Peter C Austin, Cynthia A Jackevicius, Anna Chu, Jessalyn K Holodinsky, Michael D Hill, Colleen M Norris, Mukesh Kumar, Noreen Kamal, Douglas S Lee and 5 more

Abstract readComparative Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC cardiovascular disorders, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Candace D McNaughtonICES, Toronto, ON, Canada. candace.mcnaughton@utoronto.ca.
Peter C AustinICES, Toronto, ON, Canada.ORCID 0000-0003-0095-9134
Cynthia A JackeviciusICES, Toronto, ON, Canada.
Anna ChuICES, Toronto, ON, Canada.
Jessalyn K HolodinskyDepartments of Emergency Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Michael D HillDepartment of Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
Colleen M NorrisFaculty of Nursing, Faculty of Medicine & School of Public Health, University of Alberta, Edmonton, AB, Canada.
Mukesh KumarDepartment of Industrial Engineering, Dalhousie University, Nova Scotia, Canada.
Noreen KamalDepartment of Industrial Engineering, Dalhousie University, Nova Scotia, Canada.
Douglas S LeeICES, Toronto, ON, Canada.
Nadia KhanDepartment of Medicine, University of British Columbia, Vancouver, BC, Canada.
Manav V VyasICES, Toronto, ON, Canada.
Raed A JoundiDepartment of Medicine, Division of Neurology, McMaster University, and Population Health Research Institute, Hamilton, ON, Canada.
Moira K KapralICES, Toronto, ON, Canada.
Amy Y X YuICES, Toronto, ON, Canada.

Funding

CIHR Operating grant 179897
6 · The paper itself

Abstract

backgroundHealth system disruptions since onset of the COVID-19 pandemic may have adversely impacted adherence to medications for common cardiovascular risk factors.

methodsWe examined adherence to and discontinuation of incident prescriptions for medications treating hypertension, dyslipidemia, diabetes, and atrial fibrillation in Ontario, Alberta, and Nova Scotia, Canada. We compared the recent period (April 1, 2020 through most recently available follow-up: September 30, 2021 for Ontario; March 31, 2021 for Alberta; and March 31, 2022 for Nova Scotia) to the baseline, pre-pandemic period (April 1, 2014 through March 31, 2019). In each province, people aged ≥66 years with a valid health number and corresponding incident prescription were included. For each medication class, adherence in the recent period, defined as ≥ 0.80 proportion-of-days-covered (PDC), was compared to the pre-pandemic period using modified Poisson regression with robust error variance, adjusted for patient characteristics. Similarly adjusted Cox proportional hazards models compared hazard of discontinuation over one year of follow-up between the two time periods.

resultsIn the recent period, PDC ranged from 48.9% for dyslipidemia medications in Alberta to 82.2% for anticoagulants in Nova Scotia. Adherence was not different between periods, with the following exceptions: higher adherence in the recent period for antihypertensives (adjusted risk ratios [aRR] 1.08, 95% CI 1.06-1.10) and dyslipidemics (aRR 1.07, 95% CI 1.04-1.09) in Nova Scotia, and for antihyperglycemics (aRR 1.10, 95% CI 1.08-1.14) and anticoagulants (1.15, 95% CI 1.12, 1.18) in Alberta. Adherence was lower in the recent period only for antihypertensives in Alberta (aRR 0.95, 95% CI 0.93, 0.97). One-year rates of discontinuation ranged from 20.9% for anticoagulants in the Alberta recent period to 56.7% for antihypertensives in the Ontario baseline period. The adjusted hazard of discontinuation was lower or unchanged in the recent period for all medication classes.

conclusionsDespite significant health system disruptions since 2020, recent adherence to incident cardiovascular prescriptions was similar or better than before and rates of medication discontinuation were lower. However, interventions are still needed to improve existing, suboptimal adherence.

Indexed as

Cardiovascular AgentsCOVID-19Drug PrescriptionsMedication AdherenceAgedCanadaDelivery of Health CareFemaleHumansMaleCardiovascular AgentsAtrial fibrillationCardiovascular risk factorsDiabetesDyslipidemiaHealthcare deliveryHypertensionMedication adherenceMedication discontinuation

Identifiers

PMID39910396
PMCPMC11796216

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.