The actual incidence of delayed use of a blood thinner might be greater than that reported in the study, which used data on people enrolled in major integrated health systems, Ho said. "Outside such systems, there are more people with less insurance coverage and higher co-payments, so I suspect the rate might be higher," he noted.
Ho said the study has lessons not only for people who have stents implanted but for their medical caregivers, too.
"For clinicians and hospitals, it is important to look at the discharge process to make sure patients are getting appropriate discharge instructions, and also that they understand the importance of the medications they will be taking," he said. "We as clinicians should highlight the importance of each and every medication."
On the other end, "it is important for patients to ask questions so that they have a good idea of what medications are important to take," Ho said.
Dr. Rob Califf, vice president for clinical research at Duke University, said that it's "critical for doctors and health systems to do everything possible to be sure that people both fill their prescriptions and take their medicine."
One way to do that is to return to a once-common practice of sending someone out of the hospital with a few-day's supply of prescribed medications, said Dr. Stephen A. Siegel, an assistant clinical professor of medicine at New York University. Cost-cutting has eliminated that measure in many hospitals, but it helps ensure that the medication will be taken immediately and that a prescription for it will be filled, Siegel said.
The American Heart Association has more on stents.
SOURCES: P. Michael Ho, M.D., associate professor, medicine, University of Colorado, Denver; Rob Califf, M.D., vi
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