Implementation of therapeutic recommendations in high cardiovascular-risk patients. The Polish population of EUROASPIRE V survey

Introduction: Poor medication adherence is associated with unsatisfactory health outcomes, elevated mortality, and high costs of medical care. This study aimed to assess the implementation of therapeutic recommendations in high cardiovascular-risk patients based on self-report questionnaires. Material and methods: The study included 194 patients from the Cardiology Outpatient Clinic. Two self-reported questionnaires were used to assess medication adherence: the Medication Adherence Questionnaire (MAQ) and the Adherence in Chronic Diseases Scale (ACDS). Results: Antihypertensive drugs were prescribed to 65.46% of the patients. According to the MAQ, 54.33% of them reported high adherence, 21.26% medium adherence, and 24.41% low adherence to the treatment. Lipid-lowering drugs were prescribed to 46.39% of the patients, all of whom were treated with statins. Among this group, 34.44% reported high adherence, 27.78% medium adherence, and 37.78% low adherence to pharmacotherapy. According to the ACDS, the majority of patients (45.55%) received a score indicating medium adherence (21–26 points), 39.27% high adherence ( > 26 points), and 16.75% low adherence to treatment ( < 21 points). A high level of adherence was declared by 61.54% of the patients that reached the therapeutic goal of lipid-lowering therapy, defined as LDL-C of < 2.6 mmol/L ( < 100 mg/dL). On the other hand, among the patients whose LDL-C remained elevated, 23.44% declared high adherence to treatment. There were no significant differences in achieving the intended therapeutic goal of blood pressure (BP ≤ 140/90 mmHg) in the groups with high, medium and low adherence (26.53% vs. 23.47% vs. 50.00%; p = 0.1880). Conclusion: Despite higher adherence to treatment in the patients with hypertension compared to patients with hyperlipidemia, the latter more often achieved the therapeutic goal. Declarations regarding high adherence to medication in the MAQ and in the ACDS are consistent in patients with hyperlipidemia and hypertension.