Secondary prevention of peripheral arterial disease (PAD) includes administration of antiplatelet agents, and adherence to medication is a requirement for an effective treatment. The aim of this study was to analyse adherence measured using the proportion of days covered (PDC) index separately in persistent and non-persistent patients, and to identify patient- and medication-related characteristics associated with non-adherence in these patient groups. The study cohort of 9178 patients aged ≥ 65 years in whom PAD was diagnosed in 1/-12/2012 included 6146 persistent and 3032 non-persistent patients. Non-adherence was identified as PDC < 80%. Characteristics associated with non-adherence were determined using the binary logistic regression model. In the group of persistent patients, 15.3% of subjects were identified as non-adherent, while among non-persistent patients, 26.9% of subjects were non-adherent to antiplatelet medication. Administration of dual antiplatelet therapy (aspirin and clopidogrel) and a general practitioner as index prescriber were associated with adherence in both patient groups. Our study revealed a relatively high proportion of adherent patients not only in the group of persistent patients but also in the group of non-persistent patients before discontinuation. These results indicate that most non-persistent PAD patients discontinue antiplatelet treatment rapidly after a certain period of adherence.

1st Department of Internal Medicine Faculty of Medicine Comenius University 813 69 Bratislava Slovakia

Department of Angiology Health Centre 917 01 Trnava Slovakia

Department of Organisation and Management of Pharmacy Faculty of Pharmacy Comenius University 832 32 Bratislava Slovakia

Department of Pharmacology Faculty of Medicine and Dentistry Palacky University 775 15 Olomouc Czech Republic

General Health Insurance Company 851 04 Bratislava Slovakia

Institute of Biomedicine University of Turku 20014 Turku Finland

Institute of Medical Physics Biophysics Informatics and Telemedicine Faculty of Medicine Comenius University 813 72 Bratislava Slovakia

Institute of Pharmacology and Clinical Pharmacology Faculty of Medicine Comenius University 811 08 Bratislava Slovakia

School of Pharmacy University of Eastern Finland 70211 Kuopio Finland

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