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Waiting to Fill Blood Thinner Prescription Dangerous

Stent Patients Who Wait to Fill Blood Thinner Prescription Double Their Risk of Heart Attack, Death, Study Finds

By Jennifer Warner
WebMD Health News

Reviewed By Elizabeth Klodas, MD, FACC

April 20, 2010 -- Waiting even one day to fill a prescription for blood thinners after heart stent surgery may prove risky.

A new study shows that heart stent patients who waited a day or more to fill their prescription for Plavix, a blood thinner medication, were twice as likely to suffer a
heart attack or death in the months following the procedure.

A stent is a small metal tube that is surgically implanted to prop open a clogged artery and reduce the risk of heart attack. After insertion of the stent, blood thinners are typically prescribed to prevent the artery from reclogging.

Researchers found one in six heart stent patients did not fill their prescription for blood thinner medication on the same day they were discharged from the hospital, as recommended. The average delay was three days.

“A surprising number of patients delayed filling the prescription,” researcher P. Michael Ho, MD, PhD, a cardiologist at the Denver Veterans Administration Medical Center and associate professor of medicine at the University of Colorado in Denver, says in a news release. “We expected their physicians and the health care system to be more vigilant in making sure they got their medications.”

Waiting a Day Risky

In the study, published in Circulation: Cardiovascular Quality and Outcomes, researchers examined the health records of 7,402 people who had heart stents implanted from 2004 to 2007 and were able to get prescription drugs at reduced prices through their health plans.

The results showed 16.3% of heart stent patients waited at least a day to fill their prescription for blood thinner medication and 2.2% never filled it. Those who delayed filling the first prescription also delayed getting subsequent refills of Plavix.

Over 22 months of follow-up, patients who waited a day or more to fill their blood thinner medication prescription had a 14.2% risk of heart attack or death, which was nearly double the 7.9% risk among those who filled their prescription on the day they were discharged from the hospital. The majority of excess events occurred within 30 days of discharge, underscoring the importance of getting on (and staying on) the prescribed medications right away.

Researchers found that people who waited to fill their blood thinner prescription were older and more likely to have other medical problems that required additional prescriptions.

“When cardiac patients are discharged from the hospital, they are prescribed a lot of medications and may not remember the importance of all of them, specifically [Plavix],” Ho says. “In addition, the doctors in the hospital may not know who is providing their patients follow-up care and often there is a gap in the transfer of information from inpatient to outpatient settings. We need to improve this transition period from hospital to home and make sure patients understand the importance of their medications.”

SOURCES:

Ho, P. Circulation: Cardiovascular Quality and Outcomes, April 20, 2010, early online edition.

News release, American Heart Association.

© 2010 WebMD, LLC. All rights reserved.



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