Key result
Demoralization in post-MI patients is linked to ~66% higher odds of poor treatment adherence.
Why the study?
Given the key role of treatment adherence in reducing major adverse cardiovascular events and mortality, this study aimed to identify the impact of psychosomatic factors on adherence in acute myocardial infarction patients.
Do psychosomatic factors (health anxiety, illness denial, irritable mood, and demoralization) impact treatment adherence over 2 years in survivors of acute myocardial infarction?
Cohort (n=867)
No
Do psychosomatic factors (health anxiety, illness denial, irritable mood, and demoralization) impact treatment adherence over 2 years in survivors of acute myocardial infarction?
In acute myocardial infarction survivors, psychosomatic factors including health anxiety, irritable mood, and demoralization independently predict poor 2-year medication adherence, which is associated with higher rates of major adverse cardiovascular events.
Psychosomatic screening may flag adherence risks in post-MI patients; hypothesis-generating pending interventional trials.
Backgroud: Because of the important role of adhering to treatment to reduce major adverse cardiovascular events and mortality, studying the factors affecting treatment adherence (TA) is warranted. This study aimed to identify the impact of psychosomatic factors on adhering to treatment among patients with acute myocardial infarction. Materials and Methods: This is a cohort study as a part of the Isfahan ST-segment-elevated Myocardial Infarction Cohort Study. Psychosomatic factors such as health anxiety, illness denial, irritable mood, and demoralization were assessed among 867 patients at the first visit. The patients were followed for 2 years; TA and major adverse cardiovascular events were checked annually in survivors. Results: The results from binary logistic regression applied to find the association between TA and psychosomatic factors showed that the patients with health anxiety, irritable mood, and demoralization were significantly poor adherent to treatment (odds ratio [95% confidence interval]: 1.39 [1.02, 2.73], 1.51 [1.02, 2.37], and 1.66 [1.02, 2.91]), respectively. The associations remained the same when adjusted for various potential confounders. Conclusions: Psychosomatic factors played an essential role in adhering to treatment among patients with acute myocardial infarction. As a result, appropriate psychological interventions may help the patients adhere to their treatment better.
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Roohafza et al. (2023) conducted a cohort in Acute ST-segment-elevated Myocardial Infarction (STEMI) survivors (n=867). Psychosomatic factors (health anxiety, illness denial, irritable mood, and demoralization) vs. Absence of psychosomatic factors was evaluated on Poor treatment adherence (evaluated by the 4-item Morisky Medication Adherence Scale [MMAS-4]) at 2 years (reported here for demoralization, the strongest psychosomatic predictor) (OR 1.66, 95% CI 1.02-2.91, p=0.007). Health anxiety (OR 1.39), irritable mood (OR 1.51), and demoralization (OR 1.66) were significantly associated with poor treatment adherence over 2 years in acute myocardial infarction survivors.
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