Summary:
Introduction: Many patients with ischaemic heart disease do not succeed to
approach the goal of their therapy, especially due to their inability to
adequately comply with their prescribed medication. The coexistence of many
risk factors increases the number of prescribed medications and the level of
knowledge of those factors can influence the way of which patients with
coronary heart disease deal with the medical guidelines and advice for
secondary prevention. Aim: The aim of this study is to explore the effect of
life changes of patients with coronary disease, the level of knowledge of risk
factors and the compliance with medication and the attainment of therapeutic
goals. Method: Non-experimental descriptive correlational study conducted with
personal interviews. The sample of the study included 80 patients who had
undergone PTCA or CABG and had a scheduled follow up appointment. Patients were
informed about the study protocol and informed consent was obtained. The
participants answered a short questionnaire focusing on general knowledge
questions and a short interview. Results: The sample of this study included 70
male and 10 female participants, with an average age of 66,91 (range 42-85
years). The awareness of risk factors and general knowledge varied depending on
the participants individual health condition and personal characteristics.
Specifically, patients with diabetes where more aware of the role of
hyperlipidemias (p=0.029), of diabetes mellitus (p<0.001) and exercise
(p=0.006), where patients with dyslipidemia had general awareness of the role
of obesity (p=0.010) and dyslipidemia (p<0.001). The awareness of stress as a
risk factor had a statistically significant positive co-relation to patients
that had a positive family history (p=0.023) and also to patients of a younger
age (p=0.017). Patients with hypertension and smokers had awareness of the
effects of smoking in coronary heart disease (p=0.015 and p=0.041
respectively), however smokers showed significant difference on their knowledge
of the positive effects of exercise (p=0.008). The participants’ gender and
educational level had no effect on the understanding of the disease or the life
changes needed. Specifically, regarding life changes and compliance with given
orders, the highest compliance was to the adjustment-modification of lipids/
cholesterol at a percentage of 68.8% of the participants, followed by the
compliance with more exercise (38.8%), reducing stress (36.3%) and stop smoking
(36.3%). The lowest compliance was achieved regarding glycemic control in
diabetics (15%). A big percentage of the participants was found to either
suffer from diabetes or was currently undergoing investigations regarding
diabetes. Known risk factors such as diabetes, dyslipidemia, hypertension did
not affect the compliance rate, with the exception of diabetics complying with
exercise guidelines (p=0.025) and smokers regarding dietary modifications
(p=0.049). Finally, the older age group did poorly regarding emotional stress
reduction (p=0.017). Conclusion: The compliance with medical treatment after an
ischaemic heart episode is a complex, multifactorial problem, hugely affected
by the understanding of risk factors and the need for life changes. Ongoing
education and follow up of the patient needs to focus on risk factors with a
high compliance rate such as dyslipidemia and hypertension, as well as on low
compliance ones, such as diabetes and stress.
