Investigation of the Adherence to Prescribed Treatment of the Patients with Coronary Heart Disease
Authors:   Bukovinian State Medical University. 2, Theatralna Sq., Chernivtsi 58002, Ukraine, Shuper V. O. , Shuper S. V. ,   Yuriy Fedkovich Chernivtsi National University. 2, Kotsyubinsky St., Chernivtsi 58012, Ukraine, Trefanenko I. V. ,   Bukovinian State Medical University. 2, Theatralna Sq., Chernivtsi 58002, Ukraine, Shumko G. I. ,   Bukovinian State Medical University. 2, Theatralna Sq., Chernivtsi 58002, Ukraine, Reva T. V. ,   Bukovinian State Medical University. 2, Theatralna Sq., Chernivtsi 58002, Ukraine
Published: October 2021

The purpose of the study was to investigate the adherence to secondary prevention medications among patients with coronary heart disease and identify factors associated with it. Materials and methods. We examined 40 patients diagnosed with coronary heart disease of more than 50 years old, who were prescribed with optimal medication for 1 year during hospitalization. Patients` adherence was defined according to MMS-8 Morisky values for secondary prevention medications prescribed by doctors. Also, questionnaires about individual reasons of non-compliance and for individual patient`s opinion about importance and usefulness of knowledge according to risk factors of the increase of cardiovascular mortality were designed and proposed to the patients. Simple descriptive statistics were used to elucidate the characteristics of the patient population and results from individual adherence tools. Final score was analyzed and correlation between patients’ data and level of adherence to prescribed treatment were identified. A correlation matrix (using Spearman’s coefficient) was reviewed for any evidence of collinearity. Results and discussion. Our study demonstrated higher level of non-adherence with secondary prevention medications in patients with coronary heart disease (60.0%). This fact can be explained by the socioeconomic reasons, less informative strategies from the medical staff to the patients. Severe regress of adherence was demonstrated after discharge from the hospital due to subjective improvement of the patients` condition with absence of supervision by out-patient specialists. Demographic characteristics of the patients suggested that some non-modified factors can affect compliance with the prescribed treatment. Better adherence was demonstrated by female married patients with higher educational level, with family history about cardiovascular death. Also, too much prescribed medications with difficult regime of usage with non-adequate out-patient supervision may significantly decrease adherence causing development of complications which may lead to re-hospitalizations and cardiovascular death. Our investigation demonstrated also non-complete information of the patients about lifestyle and medical risk factors of the cardiovascular mortality increase. Conclusion. The results of our study can provide useful practical information on the prevalence and severity of non-adherence among patients with coronary heart disease. Analysis of the factors influencing the adherence demonstrated the main reasons from patients and healthcare professionals affecting the level of compliance with the prescribed treatment. The step towards improving adherence can be initiated by the healthcare professional to overcome the patient's concerns about the prescribed medication. It is important to continue personal monitoring of patients by healthcare professionals in the form of regular inspections of intentional and unintentional non-adherence, including factors and reasons that may change and lead to such behavior