Supervisors info:
Ηρώ Μπροκαλάκη, Ομότιμη Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Νικόλαος Φώτος, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Στυλιανός Κατσαραγάκης, Επίκουρος Καθηγητής, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Summary:
Introduction: Decreased adherence to medication in patients with Acute Myocardial Infarction (ΑΜΙ) has significant consequences for both the patient and the health system, as it is associated with increased morbidity and mortality, and increased hospitalization costs.
Aim: To investigate the factors associated with increased or decreased adherence to medication in patients who have undergone AMI.
Method: The databases PubMed and Google Scholar was searched by using the appropriate keywords: «acute myocardial infarction», «coronary heart disease», «adherence», «compliance», «persistence», «discontinue», «non-adherence», «non-compliance» and «medication». The selection criteria for the article search were the following: a) Studies conducted in adults > 18 years with AMI, b) Studies published in the last decade, c) Primary studies, d) Studies published in English and Greek, and e) Studies that evaluated compliance with objective and subjective methods.
Results: 29 studies included in this review. Patients' adherence to medication ranged from 50.0% to 79.9%. Decreased adherence was associated with older age, female gender, lower income, absence of a partner / spouse, and long distance from the hospital. Also, beliefs about life such as chaos of life, anxiety about stroke, denial of disease, preference for traditional medicine, lack of information about the disease, and fear of side effects were found to be factors in reduced medication adherence. On the other hand, the use of cardiac drugs before AMI, diabetes mellitus and scheduling the first post-AMI review in the short term are associated with increased patient adherence. In addition, the use of mobile educational applications, the sending of reminder messages, the use of polypill and the reduction of costs have been found to increase the adherence to medication in patients with AMI.
Conclusion: Patients adherence is affected by a variety of factors, some of which are modifiable. To improve patient adherence with post-AMI medication, it is important to develop individualized interventions tailored to patient characteristics.
Keywords:
Acute myocardial infarction, Coronary heart disease, Adherence, Compliance, Persistence, Discontinue, Non-adherence, Non-compliance, Medication
