Heart patients who faithfully take their prescribed medication are significantly less likely to die suddenly than those who do not -- even when that medication turns out to be a placebo, Canadian investigators report.
"Adherence to pills may be a marker of a more general health-oriented behavior pattern," said Jane Irvine, DPhil, CPsych, head of the study.
Scientists from University of Toronto, University of British Columbia and McMaster University examined adherence to prescribed medication among 650 patients who had recently suffered a heart attack. These patients were part of a larger group of more than 1,200 patients taking part in a randomized placebo-controlled trial of the anti-arrhythmia drug amiodarone to prevent sudden cardiac death.
The investigators found that sudden cardiac death was significantly more common after twelve months among poorly adherent patients -- people who took less than two-thirds of the medication prescribed. Compared with patients who faithfully took amiodorone, poorly adherent amiodorone patients were three times as likely to die suddenly. In the placebo groups, poorly adherent patients were twice as likely to die suddenly as were those who took the placebo faithfully. The scientists report their research in the current issue of Psychosomatic Medicine.
Among a range of demographic and other variables examined by the researchers, none was able to predict adherence among those took amiodorone. Among the placebo patients, however, those who reliably took their pills were more likely to eat a heart-healthy diet and participated in a greater number of social events in the previous month.
"We speculate that people who are actively engaged in pleasurable life activities may have a stronger desire for good health and thus may be more motivated to adhere to health-promoting treatment," said Irvine.
This study was supported by a research grant from the Heart and Stroke
Foundation of Ontario and by a scholarship
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Contact: Jane Irvine, DPhil, Cpsych
jane.irvine@utoronto.ca
416-340-4800 x3299
Center for the Advancement of Health
2-Aug-1999