Psychosocial factors of adherence to medication in patients with coronary heart disease taking part in early rehabilitation. Results of a prospective multicenter follow-up study
█ Original article
DOI: 10.26430/CHUNGARICA.2017.47.6.419
Authors:
Tiringer István1, Andrássy Gábor2, Erdei Ferenc3, Kohut László4, Páder Katalin5, Simon Éva6, Szász Károly7, Veress Gábor8, Simon Attila8
1PTE-ÁOK, Magatartástudományi Intézet, Pécs
2Budapesti Szt. Ferenc Kórház, Budapest
3Békés Megyei Pándy Kámán Kórház, Kardiológiai Rehabilitációs Osztály, Gyula
4Magyar Honvédség Egészségügyi Központ, Honvédk. Kard. Rehab. Intézet, Balatonfüred
5Fővárosi Önkorm. Bajcsy-Zsilinszky Kórház és Rendelőintézet, Kardiológiai Rehabilitációs Osztály, Budapest
6Soproni Erzsébet Oktató Kórház és Rehabilitációs Intézet, Sopron
7Csongrád Megyei Mellkasi Betegségek Szakkórháza, Kardiológiai Rehabilitációs Osztály, Deszk
8Balatonfüredi Állami Szívkórház, Balatonfüred
Summary
The prognosis of coronary heart disease is greatly influenced by the reliable taking of medicines that decrease standard risk factors. Many studies have shown consequently that adherence is influenced by patients’ illness-representations, outcome expectancies, risk perceptions, social support, and emotional distress.
951 patients after acute coronary event from 7 departments for cardiac rehabilitation were enrolled consecutively (males: 67%, age: 61.5 [±9.5] years). At baseline the following factors were investigated: illness representation, anxiety and depression symptoms, perceived social support. Health-psychological factors were measured on the basis of the Health Action Process Approach theory.
After 12 months 16.1% of patients were non-adherent to statin treatment. Within 6 months 7% of patients ceased ASA-medication. Significant baseline predictors of statin non-adherence after 12 months were expectancy of side-effects, causal attributions that involved lifestyle factors. The patients’ belief in medical controllability at baseline, risk perception of a myocardial infarction predicted ASA-nonadherence positively, whereas depressive symptoms negatively. Non-adherent patients in all medication groups tended to underestimate their risk for myocardial infarction. The results of this study can be used as references to interactive communication in education programs with the aim to improve patients’ adherence to medication.
ISSUE: CARDIOLOGIA HUNGARICA | 2017 | VOLUME 47, ISSUE 6
click here to read the full article |
click here to read the pdf |