Have a Heart to Heart Discussion

Why do heart disease patients stop taking their medications?

You’ve had a heart attack. What started as chest pain ended in a life changing moment. You survived. You recovered. Now, you have to learn to live with some changes in your life. I sat down with Capital Cardiology Associates’ Clinical Pharmacist, Dr. Kate Cabral to discuss the importance of taking your medications after a cardiac event. A recent study from The Journal of the American Medical Association found that many patients stop taking their statin medication as early as 6 months after their heart attack.

Unfortunately this is a common problem with cardiac patients.

“After recovering from a heart attack, a patient will begin to feel better, get back to their everyday routines and may not feel like they need to take their medicine anymore,” noted Dr. Cabral. Statins are a cholesterol lowering drug that have been directly associated with reducing the risk of a heart attack or stroke. Statin therapy is recommended for most patients following a heart attack. See how cholesterol drugs work here.

“If a patient does not understand what the medication does or why they are on it, they may be less likely to take it” added Dr. Cabral. A cardiac patient may not be on any medications before their heart attack, yet afterwards leave the hospital with five new medications. “Between getting information about the medicines at the hospital, at the pharmacy, on the internet or even television, it is easy to feel overwhelmed,” stated Dr. Cabral. Additionally, a patient that does not fully understand the important benefits of a given medication may hear about the potential side effects associated with that medication and decide to discontinue its use. Some patients stop taking their medications after they become convinced that unrelated symptoms are due to side effects. Still other patients suffer from the so called “nocebo effect,” when a side effect is anticipated to the point that the patient develops it. A conversation with a clinical pharmacist is an opportunity to address these concerns.

Dr Kate Cabral

Kate Cabral, PHARM.D., BCPS

It takes time to process surviving a heart attack. When patients have their follow up appointment with their cardiologist after their heart attack, they have had the time to understand their heart attack, what the prescriptions do for their body and most importantly why they are on them. This is also the prime opportunity to have your questions answered.

Getting answers

Dr Kate Cabral

Dr. Cabral illustrates “how the heart works.”

Capital Cardiology Associates is unique in that we have a Clinical Pharmacist on staff to meet with patients upon request. Patients spend on average, 40 minutes during a “heart-to-heart” consultation with Dr. Cabral. “Patients just had an event, are overwhelmed, and have questions on their new medications. My background is actually in-patient pharmacy, where I would teach the patients about their medications before they left the hospital. Now, I work with the CCA cardiologists and staff to share information about cardiac medications, including how they work, their effects and evidence from research, with the patient after they have returned home and see how new medications are affecting their routine lifestyle.”

Family members and caretakers are also invited to participate in these sessions. “Yesterday I had a patient and their spouse come in with questions on herbals and supplements. They wanted some information on the 20 other medications they are taking that were not cardiac related. I was able give them some information they could use during their next visit with their primary physician.” You can read more on our Pharmacist Consultation here.

Making medications part of your life

“A study I just read showed that majority of patients who do not take their medications as prescribed do so because they simply forget,” said Dr. Cabral “If ‘not remembering’ is the main reason, how can we help? We try to come up with a way to link your medications to daily routines, such as brushing your teeth, taking the dog out, eating meals… if the prescription bottle was by the coffee maker, would you remember to take it?”

A heart attack should not be a setback. The journey to recovery includes changes in diet and exercise along with taking medications and attending your appointments. As Dr. Cabral noted, it is also critical to have a strong support network. “At Capital Cardiology Associates we have a support team built for patient success. Our health care team includes a pharmacist to make sure you are filling your prescriptions, understand your medications, and know why you are taking it.” To schedule your heart to heart pharmacist consultation with Dr. Kate Cabral, call 518-292-6000 or ask your doctor for more information.

Hands Making Heart
Written by: Michael Arce, Social Media Specialist, Capital Cardiology Associates.

JAMA Cardiology | Brief Report: Adherence to High-Intensity Statins Following a Myocardial Infarction Hospitalization Among Medicare Beneficiaries – published online April 19, 2017