A1 Refereed original research article in a scientific journal
Reinitiation and Subsequent Discontinuation of Antiplatelet Treatment in Nonpersistent Older Patients with Peripheral Arterial Disease
Authors: Wawruch Martin, Murin Jan, Tesar Tomas, Paduchova Martina, Petrova Miriam, Celovska Denisa, Havelkova Beata, Trnka Michal, Aarnio Emma
Publisher: MDPI
Publication year: 2021
Journal: Biomedicines
Journal name in source: BIOMEDICINES
Journal acronym: BIOMEDICINES
Article number: ARTN 1280
Volume: 9
Issue: 9
Number of pages: 12
DOI: https://doi.org/10.3390/biomedicines9091280
Self-archived copy’s web address: https://research.utu.fi/converis/portal/detail/Publication/67649975
The successful treatment of peripheral arterial disease (PAD) depends on adequate adherence to medications including antiplatelet agents. The aims of this study were (a) to identify the proportion of nonpersistent patients who reinitiated antiplatelet therapy and how many of them discontinued therapy after reinitiation, and (b) to identify patient- and medication-related characteristics associated with the likelihood of reinitiation and discontinuation among reinitiators. The analysis of reinitiation was conducted on 3032 nonpersistent users of antiplatelet agents aged >= 65 years, with PAD newly diagnosed in 2012. Discontinuation (i.e., a treatment gap of >= 6 months without antiplatelet medication prescription) was analysed in 2006 reinitiating patients. To identify factors associated with the likelihood of reinitiation and discontinuation, Cox regression with time-dependent covariates was used. Reinitiation was recorded in 2006 (66.2%) of 3032 patients who had discontinued antiplatelet medication. Among these 2006 reinitiators, 1078 (53.7%) patients discontinued antiplatelet therapy again. Ischemic stroke and myocardial infarction during non-persistence and bronchial asthma/chronic obstructive pulmonary disease were associated with an increased likelihood of reinitiation. University education was associated with discontinuation among reinitiators. Factors associated with the probability of reinitiation and discontinuation in reinitiators make it possible to identify older PAD patients in whom "stop-starting" behaviour may be expected.
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