Medication adherence and its determinants in myocardial infarction patients: An Indian scenario

• Main Authors: Satish Balaji Gonarkar, Priti Pravin Dhande
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Journal of Clinical and Preventive Cardiology
• Subjects: Medication adherence; Morisky 8 item scale; myocardial infarction
• Online Access: http://www.jcpconline.org/article.asp?issn=2250-3528;year=2016;volume=5;issue=1;spage=2;epage=8;aulast=Gonarkar

Background: Myocardial infarction (MI) is one of the leading causes of death. Along with lifestyle factors, poor medication adherence is one of the causes. This study was planned to find out the level of adherence in post-MI patients and its related factors. Objectives: Monitoring medication adherence in patients of MI attending cardiac outpatient department and to reveal causes of nonadherence to drug therapy in them. Methods: One hundred and one newly diagnosed MI patients were included in the study. Data collected were patient characteristics, habits, comorbidities, and drugs prescribed. Morisky 8 item scale was used to find out the medication adherence at the end of 1 st and 6 th month of cardiac event. Data were analyzed using McNemar test, Chi-square test, and logistic regression analysis. Results: Most common preventive cardiovascular drugs given were aspirin, clopidogrel, and statins, 98%, 88.1%, and 90%, respectively. Medication adherence at 6 th month post-MI was significantly decreased compared to 1 st month (P < 0.0001). Factors which were related to good adherence were associated comorbidities such as hypertension (P = 0.017), age group of 56-65 years (P = 0.049), higher education (P = 0.045), employees (P = 0.008), and nonsmoker (P = 0.023). Determinants associated with poor adherence were affordability (P = 0.02) and medication complexity (P = 0.03). Conclusion: Medication adherence in post-MI subjects of our study was seen to be reducing over 6 months due to factors such as low monthly income and low educational status of the subjects. Employed, higher educated, and those with comorbidities showed good adherence.