--- title: "Medication burden in patients with acute coronary syndromes. | Sutter Health" description: "Clinicians & policy makers need to be aware of medication burden to help address medication use during the acute coronary syndrome peri-hospitalization period." url: "https://www.sutterhealth.org/research/publications/medication-burden-in-patients-with-acute-coronary-syndromes-1055312727" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Medication burden in patients with acute coronary syndromes. # Medication burden in patients with acute coronary syndromes. Wright EA, Steinhubl SR, Jones JB, Barua P, Yan X, Van Loan R, Frederick G, Bhandary D, & Cobden D. _Am J Manag Care. 2017 Apr 1;23(4):e106-e112._ 2017-04-01 ## Abstract OBJECTIVES: Cardioprotective medications improve outcomes following acute coronary syndromes (ACS) but add to medication complexity. We set out to describe the use of these medications and quantify medication changes in patients admitted and discharged for ACS. STUDY DESIGN: Retrospective cohort study. METHODS: Using archived data from the electronic health record (EHR), we evaluated patients with ACS admitted to 1 of 2 hospitals between January 2008 and December 2012. Patients aged 18 to 89 years who were discharged with a principal diagnosis of ACS were included in the study. Descriptive statistics were compiled and medication use was compared at 3 time points: admission, discharge, and within 90 days post discharge. RESULTS: This study included 4767 patients. The mean number of total medications increased from 8.6 ± 6.5 to 11.4 ± 5.4 from admission to discharge, dropping slightly within 90 days post discharge (11.1 ± 5.2). Patients taking medications at least twice daily increased from 6.4 of 10 at admission to 9 of 10 at discharge. Cardioprotective medication use increased by a relative 76% for aspirin, 72% for statins, 85% for beta-blockers, and 29% for angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers from admission to discharge, whereas P2Y12 receptor inhibitor use increased 4-fold. CONCLUSIONS: Medication complexity among patients with ACS are high, with notable changes from admission to discharge. Awareness of the extent of medication burden provides clinicians and policy makers with insight to help address medication use during the ACS peri-hospitalization period. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/?term=wright+ea%2C+steinhubl+sr) ![J.B. Jones, Ph.D., MBA](https://dyn.mktgcdn.com/p/rIQfkoa5XfKJYCHSVrDKsACQSNJ7jTljZTHKC4Lae2E/fit=crop,gravity=auto,dpr=2,width=188,height=250,quality=100) J.B. Jones, Ph.D., MBA Principal investigator [View profile](https://www.sutterhealth.org/research/investigators/jb-jones-phd-mba-1049680984) ## Research topics - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Health Policy](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Policy%5C%22%22) - [Medical Informatics](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Medical+Informatics%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Machine learning and atherosclerotic cardiovascular disease risk prediction in a multi-ethnic population.](https://www.sutterhealth.org/research/publications/asvd-risk-prediction-in-multi-ethnic-population-1055312841) Ward A, Sarraju A, Chung S, Li J, Harrington R, Heidenreich P, Palaniappan L, Scheinker D, Rodriguez F. NPJ Digit Med. 3:125. doi: 10.1038/s41746-020-00331-1. eCollection 2020. 2020 Sep 23 - Publication ### [Should the financial link between industry and physician consultants be severed?](https://www.sutterhealth.org/research/publications/sever-financial-link-industry-md-consultants-1055312508) Immelt SJ, Gaudiani VA, Sade RM. Ann Thorac Surg. 92(3):781-7. doi: 10.1016/j.athoracsur.2011.05.087. 2011 Sep 01 - Publication ### [Policy-oriented research on improved physician incentives for higher value health care.](https://www.sutterhealth.org/research/publications/improved-md-incentives-higher-value-healthcare-1055312438) Luft HS. Health Serv Res. doi: 10.1111/1475-6773.12423. \[Epub ahead of print\] 2015 Nov 17 - Publication ### [Determinants of generic drug substitution in the United States.](https://www.sutterhealth.org/research/publications/determinants-of-generic-drug-substitution-in-the-us-1055312368) Segal JB, Onasanya O, Daubresse M, Lee CY, Moechtar M, Pu X, Dutcher SK, Romanelli RJ. Ther Innov Regul Sci. 2168479018820050. doi: 10.1177/2168479018820050. \[Epub ahead of print\] 2019 Jan 13 - Publication ### [Under diagnosis of hypertension using electronic health records.](https://www.sutterhealth.org/research/publications/under-diagnosis-of-hypertension-using-ehr-1055312667) Banerjee D, Chung S, Wong EC, Wang EJ, Stafford RS, Palaniappan LP. Am J Manag Care. 16(2):e35-42 2010 Feb 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/medication-burden-in-patients-with-acute-coronary-syndromes-1055312727#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Medication burden in patients with acute coronary syndromes."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/medication-burden-in-patients-with-acute-coronary-syndromes-1055312727#medicalscholarlyarticle","name":"Medication burden in patients with acute coronary syndromes.","headline":"Medication burden in patients with acute coronary syndromes.","abstract":"OBJECTIVES: Cardioprotective medications improve outcomes following acute coronary syndromes (ACS) but add to medication complexity. We set out to describe the use of these medications and quantify medication changes in patients admitted and discharged for ACS. STUDY DESIGN: Retrospective cohort study. METHODS: Using archived data from the electronic health record (EHR), we evaluated patients with ACS admitted to 1 of 2 hospitals between January 2008 and December 2012. Patients aged 18 to 89 years who were discharged with a principal diagnosis of ACS were included in the study. Descriptive statistics were compiled and medication use was compared at 3 time points: admission, discharge, and within 90 days post discharge. RESULTS: This study included 4767 patients. The mean number of total medications increased from 8.6 ± 6.5 to 11.4 ± 5.4 from admission to discharge, dropping slightly within 90 days post discharge (11.1 ± 5.2). Patients taking medications at least twice daily increased from 6.4 of 10 at admission to 9 of 10 at discharge. Cardioprotective medication use increased by a relative 76% for aspirin, 72% for statins, 85% for beta-blockers, and 29% for angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers from admission to discharge, whereas P2Y12 receptor inhibitor use increased 4-fold. CONCLUSIONS: Medication complexity among patients with ACS are high, with notable changes from admission to discharge. 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