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Cardiovascular medication utilization and adherence in rural and urban patients Open Access


Other title
drug utilization
medication adherence
urban population
cardiovascular disease
rural population
Type of item
Degree grantor
University of Alberta
Author or creator
Murphy, Gaetanne K
Supervisor and department
Eurich, Dean (School of Public Health Sciences)
Examining committee member and department
Simpson, Scott (Pharmacy and Pharmaceutical Sciences)
McAlister, Finlay (Medicine)
School of Public Health Sciences
Date accepted
Graduation date
Master of Science
Degree level
Rural residents face numerous barriers to health care access that have been postulated to result in decreased utilization and adherence to evidence-based medications. The objectives of this research were to examine cardiovascular medication use and adherence for rural versus urban patients with cardiovascular disease or diabetes, which were accomplished through a systematic review of published studies and a retrospective cohort study of incident heart failure patients in Alberta. The systematic review included 51 studies and found no consistent rural-urban differences in medication usage patterns. Rural residents with heart failure were less likely to receive evidence-based medications, specifically renin angiotensin system (RAS) agents or beta blockers, but exhibited similar adherence compared to their urban counterparts. Importantly, adherence with heart failure therapy was suboptimal for rural and urban patients leading to an increased risk of mortality. This research suggests that interventions to promote optimal cardiovascular medication utilization and adherence are needed.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
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