Non-adherence to at least one secondary prevention medicine was reported by 43.5% of CAD patients, with modifiable factors including aspirin prescription (OR 2.22) and specific concerns (OR 1.12).
Cross-Sectional (n=503)
No
What are the modifiable barriers to adherence to secondary prevention medicines in patients with coronary artery disease?
Non-adherence to secondary prevention medicines in CAD patients is common (43.5%) and driven by modifiable factors such as forgetfulness, concerns about harm, and practical issues like repeat prescriptions.
Background Non-adherence to secondary prevention medicines (SPMs) among patients with coronary artery disease (CAD) remains a challenge in clinical practice. This study attempted to identify actual and potential modifiable barriers to adherence that can be addressed in cardiology clinical practice. Methods This was a cross-sectional, postal survey-based study of the medicines-taking experience of patients with CAD treated at a secondary/tertiary care centre. All participants had been on SPM for ≥3 months. Results In total, 696 eligible patients were sent the survey and 503 responded (72.3%). The median age was 70 years, and 403 (80.1%) were male; the median number of individual daily doses of all medicines was 6. The rate of non-adherence to at least one SPM was 43.5% (n=219), but 53.3% of reported non-adherence was to only one SPM. Statins contributed to 66.7% and aspirin to 61.7% of overall non-adherence identified by the Single Question (SQ) tool. In 30.8% of non-adherent patients (n=65), this was at least partly intentional. Barriers included forgetfulness (84.9%; n=186), worry that medicines will do more harm than good (33.8%; n=74), feeling hassled about medicines taking (18.7%; n=41), feeling worse when taking medicines (14.2%; n=31) and not being convinced of the benefit of medicines (9.1%; n=20). In a multivariate analysis, modifiable factors associated with overall non-adherence included being prescribed aspirin (OR: 2.22; 95% CI: 1.18 to 4.17), having specific concern about SPM (OR: 1.12; 95% CI: 1.07 to 1.18) and issues with repeat prescriptions (OR: 2.48; 95% CI: 1.26 to 4.90). Different factors were often associated with intentional versus unintentional non-adherence. Conclusions Using appropriate self-report tools, patients share actual and potential modifiable barriers to adherence that can be addressed in clinical practice. Non-adherence behaviour was selective. Most non-adherence was driven by forgetfulness, concern about the harm caused by SPM and practical barriers.
Khatib et al. (Mon,) conducted a cross-sectional in Coronary artery disease (n=503). Secondary prevention medicines was evaluated on Non-adherence to at least one secondary prevention medicine. Non-adherence to at least one secondary prevention medicine was reported by 43.5% of CAD patients, with modifiable factors including aspirin prescription (OR 2.22) and specific concerns (OR 1.12).
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