Patients' perspectives on iatrogenic risk and therapeutic adherence of their cardiovascular therapies: a real-life survey

Abstract

Abstract Background Cardiovascular disease, one of the main Non-Communicable Disease (NCD), is the first cause of death in the world representing 30% of global mortality. Their prevention, early detection, reduction of risk and progression are major daily challenges. Success depends on patient adherence which is the most enigmatic and difficult challenge for the physician to assess. Our objective was to better understand Patients' Experience, including their behavior and knowledge of the risks and benefits of their treatment, as well as their perception of therapeutic adherence and iatrogenic risk. Purpose This real-world study conducted on patients affected by cardiovascular diseases, identified their views on iatrogenic risk and compliance with their condition and treatment intake. Method An online survey was conducted on the Carenity platform among adult patients affected by cardiovascular disease (CV) between February 14th and May 15th, 2020. A multiple correspondence analysis (MCA) was performed on a dataset of French patients with CV disease using a hierarchical cluster analysis. Results 403 patients (women 54%) mean age 60,6 YO with High Blood Pressure (56,6%), diabetes (28,3%), heart attack (26%), hypercholesterolemia (22%), arrythmia (19,6%), stroke (14%). Mean number of medications per day was 5,1 and 6,1 of pills. 3 groups of patients were identified as per MCA. The group 1 “at risk” (n=168) concerns the least compliant patients, mostly women. They visit more often their doctor (83%), whom they are afraid to disappoint. 46% deliberately deviate from initial prescription even if they feel compliant (73%). They consider they are less likely to have received explanation on treatment benefits (73%). They seem to be more worried about incompatibility with daily life (33%) and frequency of administration (40%). 34% are more likely to be afraid of becoming dependent and 49% lacking efficacy. 76% discuss about constraints and risks with someone. The group 2 “tolerant” (n=90) includes patients less aware with interactions with other treatments (73%) and with alcohol (64%). They do not think it is necessary to inform their doctor about compliance issues (76%). The group 3 “reporters” (n=145) concerns patients, mostly men, who feel more compliant (90%) than others. They feel informed (84%), they use practical solutions to be compliant (63%) and they are aware of treatment interactions such as tobacco (37%). Conclusion These results from the Patient Experience, suggest new patient behaviors and profiles. They focus on coping mechanisms and solutions they develop to manage their relationship with treatment. These identified profiles should be included in the Therapeutic Patient Education approach. The objective is to improve overall management by increasing compliance and reducing the iatrogenesis risk. Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): Pfizer PFE France, a Viatris company