Evidence-based prescribing and adherence to antiplatelet therapy--how much difference do they make to patients with atherothrombosis?

Antiplatelet therapy is vital for the secondary prevention of cardiovascular events in patients with atherothrombosis (acute coronary syndromes, cerebrovascular disease and peripheral arterial disease). Numerous international guidelines provide evidence-based recommendations about the optimal use of antiplatelet agents in these disease states. This article reviews the published literature in order to firstly quantify the extent to which guideline recommendations for antiplatelet agents are taken up by prescribing physicians, and the degree to which patients adhere to prescribed treatments. It then goes on to examine the consequences of non-adherence and explores ways in which adherence may be improved from the perspective of both the physician and the patient.