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dc.contributorSelkrig, L.en_US
dc.contributorAndrianopoulos, Nicken_US
dc.contributorBrennan, A.en_US
dc.contributorReid, C.en_US
dc.contributorNanayakkara, S.en_US
dc.contributorDart, A.en_US
dc.contributorWarren, J.en_US
dc.contributorSharma, Ananden_US
dc.contributorAjani, A.en_US
dc.contributorClark, D.en_US
dc.contributorFreeman, M.en_US
dc.contributorWalton, T.en_US
dc.contributorDuffy, S.en_US
dc.description.abstractBackground: Variation in access to percutaneous coronary intervention (PCI), specialist medical care, pharmacy and cardiac rehabilitation occurs across Australia. We explored the relationship between geographic location, medication adherence and long-term outcomes in patients undergoing PCI. Methods: We assessed 18,421 patients across six hospitals between August 2009 and December 2016 within the Melbourne Interventional Group registry. Patients were classified according to their place of abode as metropolitan, regional or remote utilising the ‘Cardiac Accessibility Remoteness Index Australia’ classification. Medication adherence was defined as optimal medical therapy (OMT), near-optimal medical therapy (NMT; 4 guideline-indicated medications) and sub-optimal medical therapy (SMT; ≤3 guideline-indicated medications). Results: During the study period 13,517 metropolitan, 3,990 regional and 914 remote patients underwent PCI. PCI indication was more commonly ACS for metropolitan patients (66%) vs. regional (59%) and remote (58%). Regional and remote patients were more likely to receive fibrinolysis and a bare-metal stent. Metropolitan patients were older, with more diabetes and multi-vessel disease, however there were fewer current and former smokers. Twelve-month target vessel revascularisation and MACE were higher in the regional and remote cohorts. However, National Death Index linkage demonstrated no difference in long-term mortality between geographic cohorts. Thirty-day medication adherence was similar among geographic cohorts. However, thirty-day NMT and SMT were associated with higher long-term mortality than OMT, as was 12-month SMT. Conclusions: Regional and remote patients undergoing PCI experience similar long-term outcomes as metropolitan patients. Medication adherence is associated with long-term mortality, but prescribing practices are comparable amongst metropolitan, rural and remote patients.en_US
dc.description.provenanceSubmitted by Gemma Siemensma ( on 2019-03-05T03:48:52Z No. of bitstreams: 0en
dc.description.provenanceApproved for entry into archive by Gemma Siemensma ( on 2019-04-05T05:49:59Z (GMT) No. of bitstreams: 0en
dc.description.provenanceMade available in DSpace on 2019-04-05T05:49:59Z (GMT). No. of bitstreams: 0 Previous issue date: 2017en
dc.titleGeographic variation in secondary prevention medication adherence and subsequent outcomes following percutaneous coronary intervention.en_US
dc.bibliographicCitation.conferencedateAugust 10th- 13then_US
dc.bibliographicCitation.conferencename65th Cardiac Society of Australia and New Zealand Annual Scientific Meeting and the International Society for Heart Research Australasian Section Annual Scientific Meeting.en_US
dc.bibliographicCitation.conferenceplacePerth, Australiaen_US
dc.subject.healththesaurusSPECIALIST MEDICAL CAREen_US
dc.subject.healththesaurusGEOGRAPHICAL LOCATIONen_US
dc.subject.healththesaurusMEDICATION ADHERENCEen_US
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