Key result
Among 21 preoperative vascular surgery patients, 100% believed in the need for cardiovascular medication, yet 71% reported high concern and 67% worried about long-term side effects.
Why the study?
Cardiovascular comorbidities increase perioperative risk in noncardiac surgery, but medication adherence remains low in many LMICs where health beliefs, systemic barriers, and communication pose significant challenges.
Observational (n=21)
No
Patient-reported tools are acceptable and reveal significant concerns about side effects and a lack of shared decision-making regarding cardiovascular medications before noncardiac surgery in a low- and middle-income country setting.
Answers are grounded in this paper and cite their sources.
Adherence questionnaire acceptability in LMICs remains preliminary; leaves open effects on perioperative cardiovascular risk reduction.
BACKGROUND: Cardiovascular comorbidities increase perioperative risk in patients undergoing noncardiac surgery. Optimizing medication adherence in this population is critical; yet adherence remains low in many low- and middle-income countries (LMICs), where health beliefs, systemic barriers, and healthcare communication bring significant challenges. This study aimed to explore the acceptability of validated patient-reported questionnaires and to investigate the beliefs and experiences influencing adherence to cardiovascular medication before surgery in a South African tertiary hospital. METHODS: A mixed-methods study was conducted using semistructured interviews with 21 patients taking cardiovascular medication before vascular surgery. Participants completed four validated self-report questionnaires: Brief Illness Perception Questionnaire (BIPQ), Beliefs about Medicines Questionnaire (BMQ), SHARED decision-making questionnaire, and SURE decisional conflict scale. Questionnaire responses were summarized with descriptive statistics. Thematic analysis of interview data was conducted using Braun and Clarke's six-step framework. RESULTS: Most participants perceived their illness as chronic (15/20, 75%) and their treatment as effective (18/21, 86%), yet 15 of 21 (71%) reported high concern and 9 of 21 (43%) reported emotional distress. Belief in the need for medication was strong (21/21, 100%), but 14 of 21 (67%) worried about long-term side effects and 10 of 21 (47%) described their medication as a "mystery." Shared decision-making appeared limited: only 7 of 21 (33%) recalled being asked for their views. Thematic analysis revealed seven major themes: understanding illness and treatment, health professional interactions, service access, social support, individual factors, routines, and habits. CONCLUSIONS: Patient-reported tools were acceptable and highlighted complex, interrelated factors associated with adherence. Integrating these tools into preoperative care may help identify at-risk patients and support person-centered perioperative planning in LMICs.
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Awoloto et al. (2026) conducted an observational in Cardiovascular comorbidities before vascular surgery (n=21). Cardiovascular medication adherence beliefs was evaluated on Beliefs and experiences influencing adherence to cardiovascular medication. Among 21 preoperative vascular surgery patients, 100% believed in the need for cardiovascular medication, yet 71% reported high concern and 67% worried about long-term side effects.
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