Adherence to treatment assessed with the Adherence in Chronic Diseases Scale in patients after myocardial infarction
Received 30 August 2017
Accepted for publication 6 January 2018
Published 5 March 2018 Volume 2018:12 Pages 333—340
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Johnny Chen
Agata Kosobucka,1 Piotr Michalski,1 Łukasz Pietrzykowski,1 Michał Kasprzak,2 Karolina Obońska,2 Tomasz Fabiszak,2 Mirosława Felsmann,3 Aldona Kubica1
1Department of Health Promotion, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; 2Department of Cardiology and Internal Diseases, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland; 3Laboratory of Basic Clinical Skills and Medical Simulations, Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland
Introduction: A substantial subset of patients after myocardial infarction (MI) discontinue pivotal medication early after discharge. In particular, cessation of antiplatelet treatment may lead to catastrophic ischemic events. Thus, adherence to prescribed medication in patients after MI is an issue of medical and social concern.
Purpose: The aim of the study was to evaluate the level of adherence to treatment using a newly developed scale in patients after MI treated with percutaneous coronary intervention.
Patients and methods: A single-center, prospective, observational cohort clinical study with a 6-month follow-up was performed. Patients with physical or cognitive impairment, prisoners, soldiers, and family members and coworkers of the researchers were excluded from the study. The impact of selected sociodemographic and clinical factors on adherence was evaluated in 221 patients (63 women and 158 men) aged 30 to 91 years.
Results: The results obtained with the Adherence in Chronic Diseases Scale (ACDS) ranged from 7 to 28 points; with the average and median scored being 23.35 and 24, respectively. The ACDS score reflects the level of adherence to prescribed medication. The high ACDS scores (>26 points) were obtained in 59 (26.7%) patients, intermediate scores (21–26 points) in 110 (49.8%) and low scores (<21 points) in 52 subjects (23.5%). Acute coronary syndrome (re-ACS) occurred in 18 (8.1%) patients during the follow-up period. The high-level adherence (ACDS score >26 points) was found in 11.1% of patients with re-ACS vs 28.4% of the remaining ones (P=0.1). Lower scores (mean ± standard deviation) in re-ACS patients were found for items 2 and 3 of the ACDS: 3.11±0.68 vs 3.45±0.73 (P=0.02) and 3.28±0.89 vs 3.64±0.64 (P=0.04), respectively.
Conclusion: Age and previous MI were found to be independent factors influencing adherence assessed with the ACDS.
Keywords: adherence, myocardial infarction, coronary artery disease, antiplatelet treatment
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