Key result
Action and coping plans increase cardioprotective medication adherence by ~60% in post-MI patients.
Why the study?
Discontinuation of cardioprotective medications commonly occurs early after hospital discharge for a cardiac ischemic event, and theory-based interventions could potentially promote better self-regulation and adherence.
Does a theory-based intervention improve medication adherence in patients with a history of myocardial infarction?
Does a theory-based intervention improve medication adherence in patients with a history of myocardial infarction?
Effect estimate: +60.0% increase
p-value: p=< .001
A theory-based intervention involving action and coping plans significantly improved medication adherence and surrogate cardiovascular markers in patients with a history of myocardial infarction.
Supports adopting theory-based action and coping plans in post-MI care; confirms adherence benefits in this RCT.
BACKGROUND: Patient discontinuation of cardioprotective medications after a cardiac ischemic event commonly occurs early after hospital discharge. Theory-based interventions could be effective in promoting better patient self-regulation of health-related behaviors and positive intentions to adhere to the recommended medical regimen. OBJECTIVE: The aim of this study was to evaluate the potential efficacy and feasibility of a theory-based intervention to promote adherence to cardioprotective medications. METHODS: In this mixed-methods quasi-experimental study with 3 time points, we recruited 45 participants with a positive intention to adhere and a history of myocardial infarction. They were recruited in primary care units in Brazil. Data collection occurred in 2 waves (Tb and T60). The intervention consisted of developing action and coping plans, delivered in a 30-minute face-to-face session, with face-to-face reinforcement at a 30-day interval. Quantitative data were submitted to descriptive, Wilcoxon, and McNemar analyses; qualitative data were submitted to content analysis. RESULTS: An increase in the proportion of patients adhering to medications at the end of follow-up was found (T60 - Tb, +60.0%; P < .001). In addition, a significant reduction was found for blood pressure (T60 - Tb, -8.6 mm Hg; P < .001), heart rate (T60 - Tb, -6.6 bpm; P < .001), and low-density lipoprotein (T60 - Tb, -6.2 mg/dL; P < .05). Qualitative results revealed that the intervention was feasible, with an attrition rate of zero. The intervention was found to be easy to apply to patients' daily lives, and there was adequate time for implementation. CONCLUSIONS: Our data confirm the potential efficacy of a theory-based intervention on the promotion of adherence to cardioprotective medications and on the related clinical end points, as well as its feasibility in the clinical context (Universal Trial Number: U1111-1189-9967).
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Pedrosa et al. (2021) studied History of myocardial infarction (n=45). Theory-based intervention (action and coping plans) was evaluated on Proportion of patients adhering to medications (+60.0% increase, p=< .001). A theory-based intervention utilizing action and coping plans increased the proportion of post-myocardial infarction patients adhering to cardioprotective medications by 60.0% (P<.001).
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