Patients who are motivated to perform self-care and consider the results of care to be important were more likely to adhere to a healthy lifestyle. Responsible patients were more likely to adhere to their medication. It is important to account for these elements as a part of secondary prevention strategies among patients with coronary heart disease after a percutaneous coronary intervention.

Because a healthy lifestyle predicted factors known to explain adherence, these issues should be emphasised particularly for female patients not in a close personal relationship, with low education and a shorter coronary heart disease duration with previous coronary intervention.

Background: Adherence to treatment is a crucial factor in preventing the progression of coronary heart disease. More evidence of the predictors of long-term adherence is needed. Aims: The purpose of this study was to identify the predictive factors of adherence to treatment six years after percutaneous coronary intervention. Methods: Baseline data ( n=416) was collected in 2013 and follow-up data in 2019 ( n=169) at two university hospitals and three central hospitals in Finland. The self-reported Adherence of Patients with Chronic Disease Instrument was used. Data were analysed using descriptive statistics and binary logistic regression analysis. Results: The respondents reported higher adherence to a healthy lifestyle six years after percutaneous coronary intervention in comparison to four months post-percutaneous coronary intervention; adherence was seen in their healthy behaviour, such as decreased smoking and reduced alcohol consumption. Participating in regular follow-up control predicted adherence. Support from next of kin predicted physical activity and normal cholesterol levels; this outcome was associated with close relationships, which also predicted willingness to be responsible for treatment adherence. Women perceived lower support from nurses and physicians, and they had more fear of complications. Fear was more common among respondents with a longer duration of coronary heart disease. Physical activity and male gender were associated with perceived results of care. Conclusion: Support from next of kin, nurses and physicians, results of care, responsibility, fear of complication and continuum of care predicted adherence to treatment in long term. These issues should be emphasised among women, patients without a close relationship, physically inactive and those with a longer duration of coronary heart disease.

This study provides evidence that healthcare professionals should be more aware of the individual needs for social support among patients with coronary heart disease after percutaneous coronary intervention.

Background Patient participation is essential for achieving high‐quality care and positive outcomes, especially among patients with multimorbidity, which is a major challenge for health care due to high prevalence, care complexity and impact on patients' lives. Objective To explore the patient participation related to their own care among patients with multimorbidity in primary health‐care settings. Methods A cross‐sectional survey was conducted among adult multimorbid patients who visited primary health‐care facilities. The key instrument used was the Participation in Rehabilitation Questionnaire. Data representing 125 patients were analysed using various statistical methods. Results The respondents generally felt patient participation to be important, yet provided highly varying accounts regarding the extent to which it was realized by professionals. Information and knowledge and Respect and encouragement were considered the most important and best implemented subcategories of participation. Several patient‐related factors had a statistically significant effect on patient perceptions of participation for all subcategories and as explanatory factors for perceptions of total participation in univariate models. Most patients reported active participation in health‐care communication, positively associated with patient activation and adherence. Gender, perceived health, patient activation and active participation were explanatory factors for total importance of participation in multivariate models, while patient activation was retained for realization of participation. Conclusions Multimorbid patients require individualized care that promotes participation and active communication; this approach may further improve patient activation and adherence. Poor perceived health and functional ability seemed to be related to worse perceptions of participation. Patient and public involvement The study topic importance was based on the patients' experiences in author's previous research and the need to develop patient‐centred care.