Factors Affecting Medication Adherence in Patients with Coronary Artery Disease: A Multicenter Analytical Cross-Sectional Study

Coronary artery disease (CAD) is one of the major causes of mortality and morbidity in the world. Adherence to medication regimens is essential for the long-term management of CAD. Objectives: To examine the medication adherence rate and factors associated with it in CAD patients visiting secondary or tertiary care hospitals in Peshawar. Methods: An analytical cross-sectional study was conducted in three tertiary care hospitals, Peshawar Institute of Cardiology, LRH, and Hayatabad Medical Complex. Data were collected from 246 patients aged 19–80 who had CAD for at least a year and were taking anti-anginals, anticoagulants, and/or antihypertensive agents directly or indirectly related to blood pressure control. Information was collected using a self-structured questionnaire and the 4-item Morisky Medication Adherence Scale. Results: Among the 246 participants, 52% were male, and the mean age was 56.9 ± 12 years. The majority of patients were illiterate (74%) and belonged to the middle class (55.7%). According to the MMAS-4, 40.2% of patients were observed to have great adherence; 41.1%, moderate adherence, 15% very poor adherence; and 3.7% did not comply at all. Chi-square analysis showed that there was no statistically significant association between adherence and gender (p=0.883), economic status (p=0.689), the cost of drugs (p=0.4394), and medication supply (p=0.710). Conclusions: Medication adherence among CAD patients in Peshawar was suboptimal, with less than half demonstrating good adherence. Financial difficulties, lack of disease awareness, side effects, and treatment complexity appeared to influence adherence trends.