Improving medication adherence in cardiovascular disease.
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2024-01
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Abstract
Non-adherence to medication is a global health problem with far-reaching individual-level and population-level consequences but remains unappreciated and under-addressed in the clinical setting. With increasing comorbidity and polypharmacy as well as an ageing population, cardiovascular disease and medication non-adherence are likely to become increasingly prevalent. Multiple methods for detecting non-adherence exist but are imperfect, and, despite emerging technology, a gold standard remains elusive. Non-adherence to medication is dynamic and often has multiple causes, particularly in the context of cardiovascular disease, which tends to require lifelong medication to control symptoms and risk factors in order to prevent disease progression. In this Review, we identify the causes of medication non-adherence and summarize interventions that have been proven in randomized clinical trials to be effective in improving adherence. Practical solutions and areas for future research are also proposed.
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Nelson, Adam J, Neha J Pagidipati and Hayden B Bosworth (2024). Improving medication adherence in cardiovascular disease. Nature reviews. Cardiology. 10.1038/s41569-023-00972-1 Retrieved from https://hdl.handle.net/10161/29814.
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Neha Pagidipati
Neha J. Pagidipati, MD, MPH, is an Assistant Professor of Medicine and cardiovascular disease prevention specialist. Since 2011, she has conducted research on cardiometabolic disease prevention, lifestyle modification and weight management. She is currently an NIH K12 scholar in Implementation and Dissemination Science.
Dr. Pagidipati is building the Duke Cardiometabolic Disease Prevention Program, which focuses on behavior change and risk factor management in patients with high risk of cardiovascular and metabolic diseases such as diabetes and obesity. The program’s multi-disciplinary team of cardiologists, endocrinologists, nephrologists, and hepatologists will work together to provide coordinated, team-based care to the most high-risk and complex patients in the health system.
Dr. Pagidipati’s research grants include the COORDINATE-Diabetes Trial, to improve the quality of care for patients with diabetes and cardiovascular disease across the U.S., and QuBBD: Deep Poisson Methods for Biomedical Time-to-Event and Longitudinal Data. She served as a study clinician on the large, longitudinal EXSCEL (Exenatide Study of Cardiovascular Event Lowering) trial. She is currently conducting a nation-wide study of obesity management using real-world data sources, and is a site investigator for the Baseline Health Study in collaboration with Verily Life Sciences. In addition, she is leading a large study within the Duke Health System to study heterogeneity within cardiovascular disease risk and response to weight loss interventions among individuals with obesity.
Dr. Pagidipati graduated from Harvard College and Harvard Medical School. She completed her internal medicine residency at Brigham and Women’s Hospital. During a two-year research fellowship in Global Women’s Health at the Brigham, she obtained an MPH from the Harvard School of Public Health and studied cardiovascular disease prevention in women in India. Dr. Pagidipati completed a four-year cardiology fellowship at the Duke University School of Medicine and served as Chief Research Fellow at the Duke Clinical Research Institute. In 2017, she became a faculty member of the Duke University School of Medicine School.
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