Adherence to treatment assessed with the Adherence in Chronic Diseases Scale in patients after myocardial infarction

Abstract

IntroductionA 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.PurposeThe 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 methodsA 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.ResultsThe 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.ConclusionAge and previous MI were found to be independent factors influencing adherence assessed with the ACDS.

Self-reported questionnaires for a comprehensive assessment of patients after acute coronary syndrome

“…Questionnaires are population-specific and need validation in specific clinical settings [40,41]. All presented tools were tested in patients with coronary artery disease after ACS treated with PCI [7,16,17,18,42]. Their application in populations with different diagnosis or in other cultural and language environment needs additional validation to ensure consistency and reliability of results.…”

“…The FICS allows the assessment of various aspects of patients' functioning with chronic disease in a quick and simple way, without the use of several different tools. Such an approach should allow diagnosing deficit areas in order to implement appropriate therapeutic and educational interventions [33]. The Portuguese versions of this questionnaire are currently validated.…”

Uzasadnienie interwencji motywacyjnych jako kluczowego elementu projektu wielopoziomowej edukacji i motywacji u pacjentów z zawałem serca (MEDMOTION)

“…This simple and easy-to-apply in everyday practice questionnaire has the potential to improve adherence to treatment and clinical outcome. All seven items refer to determinants of adherence associated with behaviours and factors that can indirectly influence adherence and are related to situations and patients' convictions [27][28][29][30].…”

“…It is expected that a comprehensive, multi-stage assessment of patients would improve the quality of medical care by personalising educational and therapeutic interventions [24,25]. The Readiness for Hospital Discharge after Myocardial Infarction Scale (RHD--MIS) [26] was designed for in-hospital evaluation, while the Adherence in Chronic Diseases Scale (ACDS) [27][28][29][30] and the Functioning in Chronic Illness Scale (FCIS) [31,32] were devised for the examination during follow-up visits.…”

Rationale and design of PREvalence of DyspneA in patients treated with TicagrelOR (PREDATOR) program

“…One of the reasons of ineffectiveness of antiplatelet therapy originates from low adherence and discontinuation of the therapy due to adverse events [12][13][14][15][16][17]. Dyspnea is a relatively frequent adverse event ob-served during ticagrelor therapy, and while it is usually reported as "mild" or "moderate" in intensity among patients experiencing it, it remains an overt reason for discontinuation of the assigned treatment [18].…”